Disseminated Intravascular Coagulation

Excess clotting uses up all clotting factors which leads to excessive bleeding. Microvascular thrombosis tissue ischaemia

Many causes: trauma, fat necrosis, blood incompatability, liver disease, infection, Sepsis, cancer

Treat underlying cause and give platelet transfusions

Liver disease

Makes clotting factor components and protein C and S. Damage to the liver can lead to:

  • Cirrhotic coagulopathy
  • Platelet dysfunction
  • Thrombocytopenia

Limited treatment options - platelet tx, FFP/prothrombin complex, cryoprecipitate or fibinogen concentrate

Renal disease

Drugs accumulating in renal failure (Penicillins) can bind to platelets and block their receptors.

Anaemia can lead to decreased platelet interaction which then causes more platelet function

  • Easy bruising , petechia, gum bleeding, nosebleeds etc
  • Patients with uncontrolled high BP and on dialysis increased risk of ICH

Correct Anaemia and avoid antiplatelet drugs

Vitamin K deficiency

FII, VII, IX, X deficiency

  • Prolonged PT aPTT
  • Caused by broad spec antibiotics, diet, obstructive Jaundice
  • Treat with vit K supplements