DIC resident survival guide: Difference between revisions

Jump to navigation Jump to search
Line 49: Line 49:
==Do's==
==Do's==
*The transfusion of platelets should be considered for those patients actively bleeding or at an increased risk of bleeding with a platelet count of less than 50,000 microliter.<ref name="pmid19222477">{{cite journal| author=Levi M, Toh CH, Thachil J, Watson HG| title=Guidelines for the diagnosis and management of disseminated intravascular coagulation. British Committee for Standards in Haematology. | journal=Br J Haematol | year= 2009 | volume= 145 | issue= 1 | pages= 24-33 | pmid=19222477 | doi=10.1111/j.1365-2141.2009.07600.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19222477  }} </ref>
*The transfusion of platelets should be considered for those patients actively bleeding or at an increased risk of bleeding with a platelet count of less than 50,000 microliter.<ref name="pmid19222477">{{cite journal| author=Levi M, Toh CH, Thachil J, Watson HG| title=Guidelines for the diagnosis and management of disseminated intravascular coagulation. British Committee for Standards in Haematology. | journal=Br J Haematol | year= 2009 | volume= 145 | issue= 1 | pages= 24-33 | pmid=19222477 | doi=10.1111/j.1365-2141.2009.07600.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19222477  }} </ref>
*[[Fibrinogen level should be kept at a level greater than 100mg/dl
*[[Fibrinogen]] level should be kept at a level greater than 100mg/dl
*Therapy with heparin used generally for patients with low grade DIC having predominantly thrombotic episodes such as acral ischemia and thrombophlebitis.
*Therapy with heparin used generally for patients with low grade DIC having predominantly thrombotic episodes such as acral ischemia and thrombophlebitis.



Revision as of 21:13, 24 January 2014

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]

Overview

Disseminated intravascular coagulation, is a pathological process in the body where the blood starts to coagulate throughout the whole body. This depletes the body of its platelets and coagulation factors, and there is a paradoxically increased risk of hemorrhage.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Disseminated intravascular coagulation in itself is a life-threatening condition and must be treated as such irrespective of the causes.

Common Causes

Management

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Do's

  • The transfusion of platelets should be considered for those patients actively bleeding or at an increased risk of bleeding with a platelet count of less than 50,000 microliter.[1]
  • Fibrinogen level should be kept at a level greater than 100mg/dl
  • Therapy with heparin used generally for patients with low grade DIC having predominantly thrombotic episodes such as acral ischemia and thrombophlebitis.

Dont's

  • Do not transfuse platelets or plasma based primarily on laboratory results but should generally be for patients who are bleeding.[1]
  • Don't give recombinant human activated protein C to patients with increased risk of bleeding.[1]
  • Don't give recombinant human activated protein C to patients with platelet counts < 30,000 microliter.[1]
  • Avoid the intravenous bolus injection of heparin of 50,000-10,000 units.

References

  1. 1.0 1.1 1.2 1.3 Levi M, Toh CH, Thachil J, Watson HG (2009). "Guidelines for the diagnosis and management of disseminated intravascular coagulation. British Committee for Standards in Haematology". Br J Haematol. 145 (1): 24–33. doi:10.1111/j.1365-2141.2009.07600.x. PMID 19222477.

Template:WH Template:WS