Difference between revisions of "DIC"
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| Line 9: | Line 9: | ||
=Diagnostic Algorithm= | =Diagnostic Algorithm= | ||
| − | Score of 5+ points strongly associated with DIC | + | Score of 5+ points strongly associated with DIC |
* Presence of a disease known to be associated with DIC (2 pts) | * Presence of a disease known to be associated with DIC (2 pts) | ||
* Platelets < 100k (1 pt), < 50k (2 pt) | * Platelets < 100k (1 pt), < 50k (2 pt) | ||
| Line 15: | Line 15: | ||
* PT > 3s (1 pt), > 6s (2 pt) | * PT > 3s (1 pt), > 6s (2 pt) | ||
* Fibrinogen < 1 g/L (1 pt) | * Fibrinogen < 1 g/L (1 pt) | ||
| + | |||
=Treatments= | =Treatments= | ||
* Basically don't get it. | * Basically don't get it. | ||
Revision as of 05:30, 21 October 2022
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%