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10 Disseminated Intravascular Coagulation (DIC) Facts

dic disseminated intravascular coagulation
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Disseminated Intravascular Coagulation (DIC)

1. Causes/Risk factors.

Let us first define what is DIC below.

Disseminated Intravascular Coagulation (abbreviated as DIC), is an acquired hematological disorder characterized by the abnormal clotting of blood where fibrin formation leads to micro vascular thrombi in selected organs. This disorder is known to produce multiple organ dysfunction syndrome (MODS).

The apparent derangement of the fibrinolytic system also contributes to intravascular clot formation. Normally, disseminated intravascular coagulation is never an illness but rather a complication or a result of a prolonged illness.

In other words, it is a secondary outcome of an underlying condition(s). It is associated with various clinical disorders such as: severe hepatic failure, solid cancer, sepsis and trauma (neurotrauma) among others.

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2. Categorized into two types.

Disseminated Intravascular Coagulation presents itself in two main types, namely: acute DIC and chronic DIC.

Acute DIC is usually eminent when a sudden exposure of blood to procoagulant e.g. Tissue factors (TF), thromboplastin etc. occurs hence causing intravascular coagulation. More precisely, the condition happens when the body’s compensatory hemostatic mechanism are drastically overwhelmed, leading to hemorrhage.

Chronic DIC depicts a compensated state that occurs when blood is continuously exposed to small amount of TF. Here, the compensatory mechanisms (in the liver and bone marrow) are not overwhelmed. Chronic DIC is more common among patients with compact tumors as well as those with large aortic aneurysms.

dic disseminated intravascular coagulation

3. Signs and symptoms of Disseminated Intravascular Coagulation.

The signs and symptoms of Disseminated Intravascular Coagulation relies mainly on its cause and whether the condition is chronic or acute.

Acute DIC is known to advance quickly and possesses severe risk to patients. Chronic DIC progresses more slowly (it may take weeks or months). The condition lasts longer and it does not readily present its clinical conditions unlike the Acute DIC.

In acute DIC, blood clots form within the blood vessels after which bleeding follows. However, this may not always be the case in all circumstances. This is because the first sign can be presented with serious instances of bleeding in some patients (sometimes marked with internal bleeding).

In chronic DIC, blood clots form within the blood vessels but no bleeding occurs. Sometimes Chronic DIC absolutely presents no signs or symptoms.

Generally, in DIC, clots form throughout the capillaries hence blocking or reducing blood flow in the body. This may sometimes lead to a number of complications to patients, e.g. chest pains and shallow breath when blood clots in the patient’s heart or lung blood vessels is present.

Redness, a drop in the blood pressure and swelling in the lower leg could also be symptoms of DIC. Other symptoms include paralysis, headaches and sometimes trouble with speech.

dic disseminated intravascular coagulation

4. Diagnostic tests.

The diagnosis for DIC is often dependent on a number of factors. These factors may include one or all of the following: a patient’s medical history, a physical exam and/or doctor’s test results.

Medical history looks into any illness or conditions that may trigger DIC while physical exams may simply refer to certain observations by the physician to determine blood clotting and bleeding. The doctor’s test results refer to specific results conducted on the patient’s blood to examine the blood cells and the clotting process.

There are two major categories of tests that can be conducted on a patient to complete the diagnosis. These tests include: Complete Blood Count & Blood Smear Tests; and Clotting Factors & Clotting Time Tests.

Complete Blood Count and Blood Smear Tests determine the number of red blood cells, platelets and white blood cells while the Clotting Factors and Clotting Time Tests measures the amount of protein in the blood and the overall time it takes to clot.

The most commonly conducted tests with Clotting Factors and Clotting Time Tests include: PT and PTT, Serum fibrinogen and fibrin degradation tests.

PT and PTT tests measures the length of time required for blood to clot while Serum fibrinogen (blood protein that helps blood to clot) determines how much fibrinogen is present in the blood. The last test (fibrin degradation), measures the amount of degraded fibrins. Fibrins are degradation substances formed after blood clot dissolves.

dic disseminated intravascular coagulation diagnostic

5. Demographics.

DIC has no known prevalence in gender. Both male and female stand an equal chance of developing the condition.

It is also known to affect people of all ages regardless of the geographical location. Regarding its connection with genetic factors, it also has no known genetic influence.

6. DIC Treatment.

The treatment of Disseminated Intravascular Coagulation mostly depends on the cause and the severity of the condition. The main aim of treating the condition is usually directed towards the control of the bleeding complication and reduction of clotting.

For underlying causes, immediate correction is recommended e.g. administration of a broad spectrum anti-biotic treatment for suspected gram-negative sepsis.

Patients with acute DIC require emergency treatment. Such treatment may incorporate administration of medicine, blood transfusion and even oxygen therapy.

Among the procedures, blood transfusion is the most common practice. It is usually done to replace blood lost through injury or bruise.

For patients with chronic DIC, treatment is administered by the introduction of anticoagulants or blood thinners to prevent blood coagulation.

dic disseminated intravascular coagulation treatment

7. Preventing/ Avoiding Disseminated Intravascular Coagulation.

The preventive measures for the condition can be categorized into two broad categories namely: the primary prevention methods and the secondary prevention methods.

The main aim of primary prevention focuses on either the early treatment of the condition or the treatment of underlying conditions responsible for precipitating the condition.

Secondary prevention involves active and effective treatment of the condition to repair the deranged coagulation system.

dic disseminated intravascular coagulation prevention

8. Incidence and prevalence.

According to researchers, DIC accounts for one percent of all hospitalized patients.

The scholars also attribute around 30 percent to 50 percent of DIC patients’ condition to severe sepsis with mortality rate at around 50 percent to 75 percent.

Normally, the mortality rate depends on the underlying disorder but the condition worsens the prognosis of all disorders.

dic disseminated intravascular coagulation prevalence

9. Complication.

DIC is commonly associated with organ failure. Infarction and limb ischaemia caused by DIC can be significantly fatal to organs.

Consistent internal bleeding from different body parts can also be a dangerous complication of the condition. There are also known cases of paralysis caused by DIC.

dic disseminated intravascular coagulation complication

10. Miscellaneous factors.

There are also some rare instances that could lead to the occurrence of DIC. These are situations such as heat stroke, occurrence of a lightning strike hit and snake bite.

Some recreational drugs such as cocaine could also lead to the condition. This is due to the damage of the epithelium and the release of tissue factor that they bring about.

DIC Medical School

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