Disseminated intravascular coagulation: Difference between revisions

From Citizendium
Jump to navigation Jump to search
imported>Howard C. Berkowitz
mNo edit summary
 
(2 intermediate revisions by 2 users not shown)
Line 9: Line 9:
  | journal = eMedicine Specialties > Hematology > Coagulation, Hemostasis, and Disorders
  | journal = eMedicine Specialties > Hematology > Coagulation, Hemostasis, and Disorders
  | title = Disseminated Intravascular Coagulation
  | title = Disseminated Intravascular Coagulation
  | author = Marcel M Levi, Alvin H Schmaier,
  | author = Marcel M Levi, Alvin H Schmaier
  | date = 4 October 2009
  | date = 4 October 2009
  | url = http://emedicine.medscape.com/article/199627-overview
  | url = http://emedicine.medscape.com/article/199627-overview
Line 17: Line 17:
#impaired fibrin removal due to depression of the fibrinolytic system. This impairment of endogenous thrombolysis is mainly caused by high circulating levels of the fibrinolytic inhibitor PAI-1.   
#impaired fibrin removal due to depression of the fibrinolytic system. This impairment of endogenous thrombolysis is mainly caused by high circulating levels of the fibrinolytic inhibitor PAI-1.   
==Etiologies==
==Etiologies==
[[Sepsis]] is one of the most common causes.
A wide range of causes need to be considered. <ref name=FP>{{citation
| url  = http://www.fpnotebook.com/Hemeonc/Coags/DsmntdIntrvsclrCgltn.htm
| journal = Family Practice Notebook
| title = Disseminated Intravascular Coagulation
}}</ref>
*Infection, such as:
*Infection, such as:
**Gram Negative Sepsis
**Gram Negative Sepsis
Line 31: Line 35:
**Surgery (e.g. Prostate Surgery)
**Surgery (e.g. Prostate Surgery)
**Heat Stroke
**Heat Stroke
        4. Burn injury
**Burn injury
        5. Dissecting aneurysm  
**Dissecting aneurysm  
  4. Obstetrical Complication
*Obstetrical Complication
        1. Abruptio Placentae
**[[Abruptio placentae]]
        2. Amniotic Fluid Embolism
**Amniotic fluid embolism
        3. Retained fetal products on intrauterine fetal death
**Retained fetal products on intrauterine fetal death
        4. Severe Preeclampsia
**Severe [[preeclampsia]]
        5. HELLP Syndrome
**HELLP Syndrome
        6. Acute Fatty Liver of Pregnancy  
**Acute Fatty Liver of Pregnancy  
  5. Hemolytic disease
*Hemolytic disease
        1. Thrombotic Thrombocytopenic Purpura (TTP)
**[[Thrombotic thrombocytopenic purpura]] (TTP)
        2. Hemolytic Uremic Syndrome (HUS)  
**[[Hemolytic uremic syndrome]] (HUS)  
  6. Immunologic Disorders
*Immunologic Disorders
        1. Immune complex disorders
**Immune complex disorders
        2. Allograft rejection
**Allograft rejection
        3. Incompatible blood transfusion
**Incompatible blood transfusion
        4. Anaphylaxis  
**[[Anaphylaxis ]]
  7. Metabolic
*Metabolic
        1. Diabetic Ketoacidosis
**[[Diabetic ketoacidosis ]]
  8. Miscellaneous
*Miscellaneous
        1. Shock
**[[Shock]]
        2. Snake Bite
**[[Snake (animal)bite]]
        3. Cyanotic Congenital Heart Disease
**Cyanotic Congenital Heart Disease
        4. Fat embolism
**Fat embolism
        5. Severe liver disease
**Severe liver disease
        6. Cavernous Hemangioma  
**Cavernous Hemangioma  
   
   
==References==
==References==
{{Reflist}}
{{Reflist|2}}[[Category:Suggestion Bot Tag]]

Latest revision as of 16:00, 7 August 2024

This article is developing and not approved.
 Main Article
 Discussion
Related Articles  [?]
Bibliography  [?]
External Links  [?]
Citable Version  [?]
 
https://en.citizendium.org/wiki/index.php?title=Disseminated_intravascular_coagulation&printable=yes
This editable Main Article is under development and subject to a disclaimer.

Usually in the context of critical care medicine, disseminated intravascular coagulation (DIC) is a syndrome, always produced by underlying cause(s) and not a diagnosis in itself, which has two seemingly opposite and potentially life-threatening manifestations: simultaneous disorders of clotting and hemorrhage. First, the body-wide coagulation system activates, and produces widepread but small clots (i.e., thrombi). These thrombi interfere with the ability of the blood to reach cells and deliver oxygen, and may lead to failure of multiple organs.

In the second stage, the intense coagulation can exhaust the precursors of thrombi, and produce extensive and diffuse bleeding. The bleeding can also be due to a derangement of the mechanisms of fibrinolysis, perhaps due to comsumption of a regulatory factor such as alpha2-antiplasmin.

It is usually an acute and life-threatening presentation, but also can appear in subacute or chronic disease, as a generalized thromboembolic disorder. Warnings during patient evaluation include extensive bruising around the sites of routine venepunctures.

Pathways

The main pathways leading to fibrin deposition are:[1]

  1. tissue factor-mediated thrombin generation
  2. dysfunctional physiologic anticoagulant mechanisms, such as the antithrombin system and the protein C system, which insufficiently balance this thrombin generation.
  3. impaired fibrin removal due to depression of the fibrinolytic system. This impairment of endogenous thrombolysis is mainly caused by high circulating levels of the fibrinolytic inhibitor PAI-1.

Etiologies

A wide range of causes need to be considered. [2]

References

  1. ↑ Marcel M Levi, Alvin H Schmaier (4 October 2009), "Disseminated Intravascular Coagulation", eMedicine Specialties > Hematology > Coagulation, Hemostasis, and Disorders
  2. ↑ "Disseminated Intravascular Coagulation", Family Practice Notebook
Retrieved from "https://citizendium.org/wiki/index.php?title=Disseminated_intravascular_coagulation&oldid=969842"