What is DIC?
Disseminated Intravascular Coagulation (DIC) occurs when the body’s coagulation mechanisms are activated in response to a plethora of diseases. Small blood clots appear in the blood vessels all over the body which interfere with the normal coagulation and abnormal bleeding can occur from the respiratory tract, skin, gastrointestinal tract or surgical wounds. The clots also interfere with normal blood flow to vital organs such as the kidney which may malfunction.
Other Names: Defibrination Syndrome, Consumption Coagulopathy.
Causes of DIC
- DIC may occur as a result of a number of pathological processes. Sepsis (inflammation inside the body due to some infection) is the most common cause of DIC. Other causes include tissue destruction, trauma, malignancy and obstetrical reasons.
- Acute myeloid leukemia, cancer of pancreas, stomach or prostrate.
- Abruptio placentae, amniotic fluid embolism, pre eclampsia
- Major or extensive surgery, burns
- Gram negative sepsis
- Streptococcus pneumonia, neisseria meningitidis, histoplasmosis, malaria, Rocky Mountain spotted fever.
- Miscellaneous causes include snake bite, liver disease, shock, heat stroke, vasculitis, hemangioma, hemorrhagic fever.
Diagnosis of DIC
Various tests are conducted to diagnose DIC including CBC and blood smear which will reveal if blood cells are damaged. Tests for clotting time and clotting factors are also conducted (PT and APTT). Serum fibrinogen (a protein that helps in blood clotting) is measured to know how much of it is there in the blood.
Outlook of DIC
The outlook for DIC patients depends on the underlying causes and its severity. Acute DIC is dangerous and can damage various body organs and even result in death if timely treatment is not provided. Chronic Defibrination Syndrome also has the potential of causing damage to organs. Research focuses on early detection of DIC, ways to prevent it and understanding the different clotting proteins.
Risk Factors of DIC
Disseminated Intravascular Coagulation is the result of an already existing disease or medical condition. People suffering from any of these conditions are more likely to develop DIC:
- Surgery and trauma
- Complications during pregnancy and childbirth
- People who have been bitten by poisonous snakes
Symptoms of DIC
The patient suffering from Disseminated Intravascular Coagulation becomes acutely ill and enters a state of shock. Widespread hemorrhage is observed and the common bleeding sites are nose, mouth and venipuncture sites. Extensive bruising, gangrene and renal failure are also possible. DIC may occur acutely as in the cause of amniotic fluid embolism or it may be chronic and insidious, as in carcinomatosis.
Acute Defibrination Syndrome usually causes bleeding, which in some cases, may be very severe. If DIC follows childbirth or surgery, bleeding may become uncontrollable. It can take place at the site of an injection, in the brain, on the skin, in the digestive tract, in muscles or in cavities of the body.
If DIC occurs chronically, as in people suffering from cancer, then clots, rather than bleeding, are more common. When blood tests are conducted, they may reveal that blood clotting is taking a longer time and the number of blood platelets is dropping.
Treatment for DIC
The main goal of Disseminated Intravascular Coagulation treatment is to control the clotting problems and bleeding. For this, a reversal of the primary cause and its severity is required. For those suffering from acute DIC, an emergency treatment may be required at the hospital. Treatment may include medicines, blood transfusions and oxygen therapy where oxygen is provided through mask, nasal prongs or breathing tube that goes to the windpipe. Blood transfusion is done to replace the blood that has been lost. For chronic DIC sufferers, the treatment will more likely focus on clotting problems. An anticoagulant or blood thinner may be used to prevent the formation of new blood clots.