Disseminated intravascular coagulation

Disseminated intravascular coagulation (DIC) due to intensive introduction into the bloodstream of substances causing intravascular coagulation sprinkles. Developed for all kinds of shock, major trauma (crush syndrome, and others.), Massive necrosis in organs (heart attack, gangrene , acute dystrophy and others.), Hemolysis, sepsis, overly massive transfusions of blood (more than 4 liters), especially long periods of time storage (more than 7 - 10 days), with terminal conditions, some forms of obstetric pathology (severe toxicosis pregnant, embolism mother vessels amniotic fluid, early placental abruption, uterine rupture, postpartum hemorrhage, fetal death, infection of the amniotic fluid, postpartum or postabortion sepsis ) and etc.

Clinically characterized by the sudden onset (acute forms) or slowly progressive occlusion of multiple small vessels in the organs (lungs, kidneys, liver, adrenal glands, brain, etc.), Leading to a pronounced disruption of their function. At the same time may develop thrombosis and larger vessels. So, suddenly growing in childbirth, during surgery, post-abortion, trauma or shock severe dyspnea with cyanosis suggests DIC with thromboembolic pulmonary vessels; decreased amount of urine (up to complete anuria) - a violation of the microcirculation in the kidneys. This can occur jaundice due to hemolysis and impaired blood circulation in the liver. Blood clotting in the early stages of the syndrome dramatically increased (blood due to the rapid collapse of the veins get hard). However, after this phase (hypercoagulable state and thrombotic), which are often short-lived, the phase of bleeding and reduce blood clotting. It manifests itself by bleeding wounds (in operations), the advent of extensive bruising, profuse uterine (after childbirth, abortion), nasal, gastrointestinal and other bleeding. Leaking blood clots poorly, small bunches and loose, sometimes there are no (phase full incoagulability blood). Thus, at DIC activation occurs first, then the depletion of blood coagulation: sharply reduced fibrinogen and other clotting factors, thrombocytopenia occurs in the blood, there are many toxic protein decomposition products.

Treatment should be in intensive care units or intensive care units. It includes as quickly as possible the elimination of the cause of the syndrome. Pathogenetic treatment (intravenous drip of heparin under the control of blood clotting, jet transfusion of fresh frozen plasma, blood loss greater compensation only svezhetsitratnoy blood). In order to eliminate acute respiratory failure promptly connected devices for mechanical ventilation; for the relief of acute renal failure using reopoliglyukina infusion, diuretics. In the phase of full blood incoagulability further intravenous high doses antienzymes -. Kontrikala etc. Timely treatment of the underlying disease usually can cut DIC ..

Prevention includes the prevention of infectious complications and sepsis, proper preparation for childbirth and operations.