Health Encyclopedia

Disseminated intravascular coagulation (DIC)

Definition

Disseminated intravascular coagulation (DIC) is a serious disorder in which the proteins that control blood clotting become abnormally active.

Alternative Names

Consumption coagulopathy

Causes, incidence, and risk factors

Normally, when you are injured, certain proteins in the blood become activated and travel to the injury site to help stop bleeding. However, in persons with DIC, these proteins become abnormally active.

Small blood clots form within the blood vessels. Some of these clots can clog up the vessels and cut off blood supply to various organs such as the liver or kidney. These organs will then stop functioning. Over time, the clotting proteins become "used up." When this happens, the person is then at risk for serious bleeding from even a minor injury.

This disorder can result in clots or, more often, in bleeding. The bleeding can be severe.

Risk factors for DIC include:

Blood transfusion reaction
Cancer, including leukemia
Infection in the blood by bacteria or fungus
Pregnancy complications (such as retained placenta after delivery)
Recent surgery or anesthesia
Sepsis (an overwhelming infection)
Severe liver disease
Severe tissue injury (as in burns and head injury)

Symptoms

Bleeding, possibly from multiple sites in the body
Blood clots
Drop in blood pressure
Sudden bruising

Signs and tests

The following tests may be done:

Examination of a blood sample under a microscope
Fibrin degradation products - high
Partial thromboplastin time (PTT) - high
Platelet count - low
Prothrombin time (PT) - high
Serum fibrinogen - low

Treatment

The goal is to determine and treat the underlying cause of DIC.

Blood clotting factors will be replaced with plasma transfusions. Heparin, a medication used to prevent clotting, is sometimes used also.

Expectations (prognosis)

The outcome depends on what is causing the disorder.

Complications

Lack of blood flow to arms, legs, or vital organs
Severe bleeding
Stroke

Calling your health care provider

Go to the emergency room or call 911 if you have bleeding that won't stop.

Prevention

Get prompt treatment for conditions known to bring on this disorder.

References

Levi M. Disseminated intravascular coagulation: What's new? Crit Care Clin. Jul 2005; 21(3): 449-67.

DeLoughery TG. Critical care clotting catastrophies. Crit Care Clin. Jul 2005; 21(3): 531-62.

Gando S. A multicenter, prospective validation of disseminated intravascular coagulation diagnostic criteria for critically ill patients: comparing current criteria. Crit Care Med. Mar 2006; 34(3): 625-31.

Review Date:5/19/2008
Reviewed By:Sean O. Stitham, MD, private practice in Internal Medicine, Seattle, WA; Jatin M. Vyas, MD, PhD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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