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Created page with "=Most Common Etiologies= * '''Bacterial sepsis''' (83%), '''Trauma''' (31%), '''Cancer''' (e.g. APML, 6.8%), placental abruption, preeclampsia, amniotic fluid embolism, burn,..."
=Most Common Etiologies=
* '''Bacterial sepsis''' (83%), '''Trauma''' (31%), '''Cancer''' (e.g. APML, 6.8%), placental abruption, preeclampsia, amniotic fluid embolism, burn, hyperthermia, rhabdomyolysis, infection, transfusion reaction (ABO incompatibility), snake venom, aortic aneurysm
Pathogenesis
* Expression of the transmembrane glycoprotein TF (which activates factor VII and the extrinsic pathway)
* Consumption of clotting factors
* Widespread micro and macrovascular thrombosis, depletion of fibrinogen and fibrin clot formation
* Platelets are trapped in the clots
* Plasminogen --> Plasmin also upregulated, leading to large increase in clot breakdown and release of [[FDPs]].
=Diagnostic Algorithm=
Score of 5+ points strongly associated with DIC=
* Presence of a disease known to be associated with DIC (2 pts)
* Platelets < 100k (1 pt), < 50k (2 pt)
* Fibrin degradation products (FDPs) (e.g. d-dimer): moderate increase (2 pt), strong increase (3 pt)
* PT > 3s (1 pt), > 6s (2 pt)
* Fibrinogen < 1 g/L (1 pt)
=Treatments=
* Basically don't get it.
* Treat underlying condition
* Treatment is lousy. Evidence behind treatment is likewise lousy.
* Platelets, cryo, FFP
=Mortality=
*20-50%
* '''Bacterial sepsis''' (83%), '''Trauma''' (31%), '''Cancer''' (e.g. APML, 6.8%), placental abruption, preeclampsia, amniotic fluid embolism, burn, hyperthermia, rhabdomyolysis, infection, transfusion reaction (ABO incompatibility), snake venom, aortic aneurysm
Pathogenesis
* Expression of the transmembrane glycoprotein TF (which activates factor VII and the extrinsic pathway)
* Consumption of clotting factors
* Widespread micro and macrovascular thrombosis, depletion of fibrinogen and fibrin clot formation
* Platelets are trapped in the clots
* Plasminogen --> Plasmin also upregulated, leading to large increase in clot breakdown and release of [[FDPs]].
=Diagnostic Algorithm=
Score of 5+ points strongly associated with DIC=
* Presence of a disease known to be associated with DIC (2 pts)
* Platelets < 100k (1 pt), < 50k (2 pt)
* Fibrin degradation products (FDPs) (e.g. d-dimer): moderate increase (2 pt), strong increase (3 pt)
* PT > 3s (1 pt), > 6s (2 pt)
* Fibrinogen < 1 g/L (1 pt)
=Treatments=
* Basically don't get it.
* Treat underlying condition
* Treatment is lousy. Evidence behind treatment is likewise lousy.
* Platelets, cryo, FFP
=Mortality=
*20-50%