Disseminated Intravascular Coagulation(DIC)

Posted by e-Medical PPT Thursday, August 19, 2010
Disseminated intravascular coagulation (DIC) is a pathological activation of coagulation mechanisms that happens in response to a variety of diseases. DIC leads to the formation of microthrombi inside the blood vessels throughout the body.As the microthrombi consume coagulation proteins and platelets, normal coagulation is disrupted and abnormal bleeding occurs from the skin , the gastrointestinal tract, the respiratory tract and surgical wounds.
In DIC, the processes of coagulation and fibrinolysis are dysregulated, and the result is widespread clotting with resultant bleeding. One critical mediator of DIC is the release of tissue factor. TF binds with coagulation factors that then triggers the extrinsic pathway which subsequently triggers the intrinsic pathway of coagulation.Excess circulating thrombin results from the excess activation of the coagulation cascade. The excess thrombin cleaves fibrinogen, which ultimately leaves behind multiple fibrin clots in the circulation. These excess clots trap platelets to become larger clots, which leads to microvascular and macrovascular thrombosis. This lodging of clots in the microcirculation, in the large vessels, and in the organs is what leads to the ischemia, impaired organ perfusion, and end-organ damage that occurs with DIC.Simultaneously, excess circulating thrombin assists in the conversion of plasminogen to plasmin, resulting in fibrinolysis. The breakdown of clots results in excess amounts of FDPs, which have powerful anticoagulant properties, contributing to hemorrhage.
Definitive diagnosis of DIC depends on the result ofThrombocytopenia,Prolongation of prothrombin time and activated partial thromboplastin time,A low fibrinogen concentration and Increased levels of fibrin degradation products.

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