Disseminated Intravascular Coagulation Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Disseminated intravascular coagulation ( Disseminated intravascular coagulation / DIC ) is a condition of impaired blood flow characterized by excessive blood coagulation and causes blockages (thrombus) in blood vessels in various organs.
At the same time as blood coagulation in an organ in the body, bleeding also occurs in other organs. This is what causes DIC to be very severe and can cause death.
Disseminated intravascular coagulation, or DIC for short, is rare. Data states that this condition is experienced by one in 100 people undergoing treatment at the hospital. DIC must always be preceded by some serious disease and does not occur in people who were previously healthy.
Symptoms
Symptoms of disseminated intravascular coagulation can vary greatly, depending on the location of the blood vessel blockage and the location of the bleeding. However, the most common symptoms are:
- Bleeding, which can be in the form of nosebleeds, bleeding gums, vomiting blood, black liquid bowel movements, and lots of red spots on the skin.
- Consciousness is disturbed, can be in the form of disorientation, and tends to be drowsy, or unconscious.
- Severe shortness of breath due to blockage in the pulmonary arteries.
- Acute kidney failure is characterized by small amounts of urine, nausea, and vomiting.
- Liver failure is characterized by yellow in the eyes and skin, increasingly enlarged stomach, and swelling of the limbs and face.
- Gangrene (decay of the ends of the fingers and toes which can be more widespread).
- Deep vein thrombosis ( deep vein thrombosis / DVT) which is characterized by swelling on one side of the leg, accompanied by redness, pain, and the leg feels warmer.
Reason
DIC occurs due to the overactivity of blood clotting factors. This can happen due to various diseases. Among others are:
- Severe infection
- Sepsis (inflammation throughout the blood circulation due to infection with disease germs)
- Inflammation of the pancreas (pancreatitis)
- Cancer
- Complications in pregnancy such as placental abruption, severe preeclampsia and eclampsia
- The fetus dies in the womb ( intrauterine fetal death / IUFD)
- Severe antiphospholipid syndrome
- Liver cirrhosis
- Injury to the brain and nerves
- Extensive burns
- Snakebite
- Blood transfusion reaction
Diagnosis
To determine the presence of disseminated intravascular coagulation, there are several laboratory tests that must be performed. These tests are platelet examination, activated partial thromboplastin time, prothrombin time, fibrinogen, and D-dimer. This examination will be needed by the doctor to determine the condition of blood clots in the patient’s body.
Other tests to assess the function of various organs are also performed. Among others are:
- Examination of urea and creatinine to assess kidney function
- Examination of SGOT, SGPT, and albumin to assess liver function
- Chest X-ray to see pictures of the lungs and heart
Treatment
Because DIC is always preceded and triggered by other diseases, treating the disease that triggers DIC is of the utmost importance. For example, DIC is triggered by a severe infection, so the treatment for this infection must be carried out properly and optimally.
In addition, some special things that must be done so that DIC can be resolved are:
- Prevents fluid loss and shock from bleeding
- Stop bleeding
- Overcome blockages that occur in blood vessels
To prevent fluid deficiency and shock due to bleeding, the patient will be given intravenous fluids as needed. Then to stop the bleeding, the doctor will consider the need for a platelet transfusion or a clotting factor transfusion.
To overcome blockages that occur in blood vessels, generally anti-coagulant types of blood thinners such as heparin or low molecular weight heparin (LMWH) are given in low doses.
Prevention
DIC is always triggered by serious illnesses such as severe infections, cancer, serious injuries, and so on. If the disease does not occur, then DIC will not occur either.