Changes

** Most Common Etiologies

** 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

*** '''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

** Pathogenesis

*** Expression of the transmembrane glycoprotein TF (which activates factor VII and the extrinsic pathway)

*** Expression of the transmembrane glycoprotein TF (which activates factor VII and the extrinsic pathway)

*** Platelets are trapped in the clots

*** Platelets are trapped in the clots

*** Plasminogen --> Plasmin also upregulated, leading to large increase in clot breakdown and release of [[FDPs]].

*** 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

** Diagnostic Algorithm: 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)

*** 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 and Evidence Behind Them:  

** Treatments and Evidence Behind Them:  

*** Basically don't get it.  

*** Basically don't get it.  

*** Treatment is lousy. Evidence behind treatment is likewise lousy.

*** Treatment is lousy. Evidence behind treatment is likewise lousy.

*** Platelets, cryo, FFP

*** Platelets, cryo, FFP

** Morbidity/Mortality is 20-50%

** Morbidity/Mortality is 20-50%