Disseminated intravascular coagulation

Background

1. Distinguishing the coagulopathy of severe liver disease from DIC is difficult

Abnormal laboratory values, including decreased platelets, decreased coagulation factors, and hypofibrinogenemia can be present in both conditions. However, the D-dimer assay should be normal or only minimally elevated from liver disease alone.

Causes

1. infection
2. carcinoma
3. acute leukemia
4. trauma (head)
5. shock
6. liver disease
7. pregnancy
8. vascular disease
9. envenomation
10. ARDS
11. transfusion reaction

Diagnosis

1. PT high
2. PTT high
3. Platlet low
4. Fibrinogen low
5. FDP high
6. D-dimer high
7. RBCs fragmented

Treatment

See Heme: Bleeding Treatment

Source

1/26/06 DONALDSON (addapted from Tintinalli)