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Disseminated intravascular coagulation (DIC)

Definition

Disseminated intravascular coagulation (DIC) is a serious disorder in which the proteins that control blood clotting are abnormally active.

Alternative Names

Consumption coagulopathy

Causes, incidence, and risk factors

Normally, when you are injured, certain proteins are turned on and travel to the injury site to help stop bleeding. However, in persons with DIC, these proteins are abnormally active. Small blood clots form throughout the body. Overtime, the clotting proteins become "used up" and are unavailable during times of real injury.

This disorder can result in clots or, more often, bleeding. Bleeding can be severe.

Risk factors for DIC include:

• Blood transfusion reaction
• Cancer, including leukemia
• Infection in the blood by bacteria or fungus
• Pregnancy complications (such as retained placenta after delivery)
• Recent surgery or anesthesia
• Sepsis
• Severe liver disease
• Severe tissue injury (as in burns and head injury)

Symptoms

• Bleeding, possibly from multiple sites in the body
• Blood clots
• Sudden bruising

Signs and tests

The following tests may be done:

• Serum fibrinogen - low
• Prothrombin time (PT) - high
• Partial thromboplastin time (PTT) - high
• Platelet count

Treatment

The goal is to determine and treat the underlying cause of DIC.

Blood clotting factors will be replaced with plasma transfusions. Heparin, a medication used to prevent thrombosis, is sometimes used in combination with replacement therapy.

Expectations (prognosis)

The underlying disease that causes the disorder will usually predict the probable outcome.

Complications

• Severe bleeding
• Stroke
• Lack of blood flow to arms, legs, or organs

Calling your health care provider

Go to the emergency room or call 911 if you have continued bleeding of unknown cause.

Prevention

Get prompt treatment for conditions known to bring on this disorder.

References

Levi M. Disseminated intravascular coagulation: What's new? Crit Care Clin. Jul 2005; 21(3): 449-67.

DeLoughery TG. Critical care clotting catastrophies. Crit Care Clin. Jul 2005; 21(3): 531-62.

Gando S. A multicenter, prospective validation of disseminated intravascular coagulation diagnostic criteria for critically ill patients: comparing current criteria. Crit Care Med. Mar 2006; 34(3): 625-31.

Review Date:2/6/2007
Reviewed By:William Matsui, MD, Assistant Professor of Oncology, Division of Hematologic Malignancies, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD. Review provided by VeriMed Healthcare Network.

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