Disseminated Intravascular- Coagulability is defined as a widespread of intravascular fibrin formation in response to an excess blood protease activity that overcomes the natural anticoagulant mechanisms (Arruda & High, 2018, p. 834). Patients with DIC will show signs and symptoms of bleeding from the venipuncture sites, petechiae, ecchymoses, to severe hemorrhage from the gastrointestinal tract, lung and into the CNS. A prolonged prothrombin time, aPTT, platelets of 100,000 /uL or a rapid decline in platelet numbers in the presence of schistocytes in the blood smear and an elevated levels of fibrin degradation product are some of the most common laboratory findings in patient with DIC (Arruda & High, 2018, p. 835).
Patients who are actively bleeding or those who at high- risk of bleeding or those who have a platelet count of less than 10000 to 20000/uL should receive fresh frozen plasma or platelet concentrates (p. 836). According to the prothrombin time of more than 1.5 times the normal is a good indicator of the severity of clotting factor consumption this patient may need a replacement of fresh frozen plasma. Patients who have a low fibrinogen or a brisk hyperfibrinolysis may need a cryoprecipitate. Some of the risk factors that providers need to consider when treating patients with DIC is to whether give an anticoagulation such as heparin, antithrombin III concentrates or anti-fibrinolytic drugs. Providers need to avoid giving antifibrinolytic agents such as tranexamic acid (TXA), epsilon-aminocaproic acid (EACA) or aprotini and prothrombin complex concentrates (PCC) in patients with DIC due to a blockage of the fibrinolytic system that can increase the risk of thrombotic complications (Leung, 2021).
Arruda, V.R. & High, K.A. (2018). Coagulation Disorders. J.L. Jameson, D.K. Kasper, D.L., Longo, A.S.Fauci, S.L. Hauser & J.Loscalzo (Eds). Harrison’s Principles of Internal Medicine (20th ed, Vol. 1, pp. 830-838). Library of Congress Catagaloging- in publication data.
Leung, L.L.K. (2021). Disseminated intravascular coagulation (DIC) in adults: Evaluation and management. Retrieved from https://www.uptodate.com/contents/disseminated-intravascular-coagulation-dic-in-adults-evaluation-and-management?search=dic§ionRank=2&usage_type=default&anchor=H4101269295&source=machineLearning&selectedTitle=1~150&display_rank=1#H1274217204