★ DIC (disseminated intravascular coagulation) 파종성 혈관 내 응고

 

Acute disseminated intravascular coagulation 파종성 혈관 내 응고 

✔️ Precoagulant exposure: Bacteria, Malignancy, Trauma, Placental abruption

      → Activation fo coagulation cascade & platelets → Microthrombus → Fibrinolysis 

      → Lab: PT & PTT ⬆️ Plt & fibrinogen ⬇️ Fragmented RBC, D-dimer ⬆️

 Associated laboratory findings include decreased platelet count and fibrinogen level with prolonged clotting times (ie, PT, PTT)

 

Manifestations

• external bleeding (eg. gums, nose, IV sites)
• internal bleeding (eg. petechiae, ecchymosis)
• organ damage frome clot formation (ie. respiratory distress, renal insufficiency)
• Care is supportive and focuses on treating underlying cause.

Intervention

 

• Initiating vasopressors (ie, norepinephrine infusion) to increase blood pressure and restore tissue perfusion.
• Monitoring coagulation studies (eg, PT/PTT, fibrinogen, platelets) to assess the severity of DIC and evaluate the effectiveness of interventions.
• Transfusing fresh frozen plasma and platelets for clients with severe bleeding to replace clotting factors and reduce blood loss.

 

Educational objective:
Disseminated intravascular coagulation (DIC) is a life-threatening disorder triggered by an underlying condition (ie, sepsis) that causes widespread activation of the coagulation cascade with abnormal clot formation and hemorrhage.  Interventions (ie, initiating vasopressors, monitoring coagulation studies, transfusing fresh frozen plasma and platelets) are supportive and focus on treating the underlying cause (ie, antibiotics).

 

 

산모 DIC Intervention

• Performing frequent fundal masage: 자궁 수축을 도와 출혈을 줄인다
• Inserting a urinary catheter: to monitor renal function (ie. urine output) and prevent bladder distension that may contribute to hemorrhage
• prepare rapid transfusion of blood product
• Oxygen (ie. nonbreather face mask)