DISSEMINATED

INTRAVASCULAR
COAGULATION (D.I.C)
Reporters:
Guatlo, Jaymark
Rubio, Clarissa
Saplan, Alyana
Macrohon, Denise
Entero, Claire

Definition:

DIC is not a disease but a sign of an

underlying condition.

DIC may be triggered by sepsis,

trauma, cancer, shock, abruptio
placentae, toxins, or allergic reactions.

The severity of DIC is variable, but it is

potentially life-threatening.

Disseminated intravascular coagulation(DIC), is a

condition in which blood clots form throughout the
body's small blood vessels. These blood clots can
reduce or block blood flow through the blood
vessels, which can damage the body's organs.

Internal bleeding occurs inside the body. External

bleeding occurs underneath or from the skin or
mucosa. (The mucosa is the tissue that lines
some organs and body cavities, such as your
nose and mouth.)

Pathophysiology
In DIC, a systemic activation of the
coagulation system simultaneously
leads to thrombus formation
(compromising blood supply to
various organs) and exhaustion of
platelets and coagulation factors
(results in hemorrhage). This is a
disruption of body homeostasis.

Thrombosis-brief period
of hypercoagulability
1)
Coagulation cascade
is initiated, causing
widespread fibrin
formation
2)
Micro thrombi are
deposited throughout
he microcirculatory
3)
Fibrin deposits result
in tissue ischemia,
hypoxia, necrosis
4)
Leads to multi organ
dysfunction

Fibrinolysis-period of
hypocoagulability (the
hemorrhagic phase)
1)
Activates the complement
system
2)
Byproducts of Fibrinolysis
(fibrin/fibrin degradation
products(FDP)) further
enhance bleeding by
interfering with platelet
aggregation, fibrin
polymerization, &
thrombin activity
3)
Leads to Hemorrhage

Clinical Manifestations

Patients with frank DIC may bleed from:

Mucous Membranes
Venipuncture Sites
GI and Urinary Tract

The bleeding can range from minimal

occult internal bleeding to profuse
hemorrhage from all Orifices.

Patients typically develop multiple organ

dysfunction syndrome (MODS) may exhibit:

Renal failure
As well as Pulmonary and Multifocal central
nervous system infarctions as a result of
Microthromboses, Macrothromboses, or
Hemorrhage.

Initially the bleeding is subtle, but it can

develop into frank hemorrhage. Signs and
Symptoms, which depend on the organs
involve.

DIAGNOSIS/LAB
FINDINGS
Test
Platelet count
Fibrin degradation product
(FDP)
Factor assay
Prothrombin time (PT)
Activated PTT
Thrombin time
Fibrinogen
D-dimer
Antithrombin

Abnormality
Decreased
Increased
Decreased
Prolonged
Prolonged
Prolonged
Decreased
Increased
Decreased

Medical Management

The most important management factor in

DIC is treating the Underlying cause; until
the cause is controlled, the DIC persist.

Correcting the secondary effects of tissue

ischemia by improving:
Oxygenation
Replacing Fluids
Electrolyte imbalances

And administering Vasopressor Medications.

If serious Hemorrhage occurs, MUST BE
REPLACE.

Cryoprecipitate

This component, either derived from whole blood or

collected via apheresis, is prepared by thawing fresh
frozen plasma between 16 C and recovering the
precipitate. The cold-insoluble precipitate is refrozen.
One unit of cryoprecipitate apheresis is approximately
equivalent to 2 units of cryoprecipitate derived from
whole blood.
It contains most of the factor VIII, fibrinogen, factor
XIII, von Willebrand factor and fibronectin from fresh
frozen plasma.
Cryoprecipitate derived from whole blood is available
in all ABO groups.

Heparin

is an anticoagulant (blood thinner) that prevents

the formation of blood clots.
Heparin is used to treat and prevent blood clots
in the veins, arteries, or lung. Heparin is also
used before surgery to reduce the risk of blood
clots.
Heparin injection should not be used to flush
(clean out) an intravenous (IV) catheter. A
separate product is available to use as catheter
lock flush.

Nursing Management

Nurses need to be aware of which patients are at risk

for DIC.
Patients need to be assessed thoroughly and frequently
for signs and symptoms of thrombi and bleeding and
monitored for any progression of these signs:
Integumentary System
Circulatory and Respiratory System
Gastrointestinal System
Renal System
Neurologic System

Assessment and Interventions should target

potential sites of end-organ damage. As
organs become ischemic from microthrombi,
organ function diminishes like;
Kidney Failure
Lungs
Brain
Skin (Particularly Vulnerable)
Nurses Family Support.

END