Disseminated intravascular coagulation

Disseminated intravascular coagulation

 Disseminated intravascular coagulation is a disorder whereby the small blood clots develop throughout the bloodstream, thereby impeding the blood vessels. The rising clotting exhausts the platelets, and clotting aspects necessitated to regulate bleeding, thus causing excessive bleeding. In this complex syndrome, excessive intravascular coagulation results in diffused microthromboses and failure of the multiple organs. The inactivation and excess consumption of platelets and clotting aspects cause absurd bleeding at the same time. The condition is not a primary illness though a secondary complication of many disorders. It entails a dynamic phenomenon whereby the status and laboratory coagulation test outcomes might fluctuate markedly, quickly, and repetitively. It is most and less dominant in dogs and cats.

Signs and symptoms

Disseminated intravascular coagulation tends to cause both external and internal bleeding. The internal bleeding can happen in organs, including intestines, brain, and kidneys. The signs and symptoms of this disorder entail the blood in the urine due to bleeding from bladder or kidney, blood in the stools because of bleeding in the stomach and intestines, headache as a result of bleeding in the brain, and external bleeding underneath the skin (Tanigawa et al. 640).

Diagnosis

Blood tests might indicate that the number of platelets in a sample of blood has decreased and that the blood is consuming too much time to clot. The diagnosis of the disorder is confirmed when the test results indicate an abnormal increase in the amount of plasma D-dimer and always decreasing fibrinogen levels. The plasma D-dimer is a substance that constitutes the release of blood clots when they break down. When there are fewer amounts of plasma D-dimer, this shows that there are fewer clots that are produced than usual.

Treatment.

Treatment of disseminated intravascular coagulation entails the correction of the cause and substitution of platelets, coagulation aspects, and fibrinogen to regulate severe bleeding. The underpinning disorder should be recognized and corrected whether it is an infection, cancer, or an obstetric problem. The disseminated intravascular coagulation that develops is dreadful and should be treated as an emergency. Platelets and clotting aspects are transfused to substitute those depleted and to cease bleeding. The clotting problem subsides whenever the cause is remedied (Levi et al. 845).  Heparin is used as therapy for patients with slowly growing disseminated intravascular coagulation who have venous thromboembolism. It might be used to slow the clotting of people who suffer from chronic and mild disseminated intravascular coagulation whereby clotting is an issue than bleeding. Heparin is essential in treating slowly evolving disseminated intravascular coagulation with venous thrombosis embolism. It is often not indicated in quickly evolving disseminated intravascular coagulation with bleeding (Squizzato et al. 897). An exception can be demonstrated in women with a retained dead fetus and evolving disorder with a progressive reduction of platelets coagulation aspects, and fibrinogen. Heparin is given for many days to regulate the disorder, raise platelet and fibrinogen levels, and reduce the excessive consumption of the coagulation factors. Ultimately, heparin is ceased, and the uterus is evacuated.

Conclusion

Disseminated intravascular coagulation is a secondary phenomenon, and this implies that it is predictable. It happens in acute or chronic form, and thereby it can be expected in the latter form. Insufficient resuscitation is the commonest cause, and therefore it is preventable by early intervention. Early diagnosis with immediate treatment should involve the correction of the cause and substitution of platelets, coagulation aspects, and fibrinogen to regulate severe bleeding.

Works Cited

Levi, Marcel, and Marie Scully. “How I treat disseminated intravascular coagulation.” Blood, The Journal of the American Society of Hematology 131.8 (2018): 845-854.https://doi.org/10.1182/blood-2017-10-804096

Squizzato, Alessandro, et al. “Supportive management strategies for disseminated intravascular coagulation.” Thrombosis and haemostasis 116.05 (2016): 896-904.

Tanigawa, Tomohiko, et al. “Angiosarcoma Identified by Diffuse Alveolar Hemorrhaging Associated with Disseminated Intravascular Coagulation.” The Journal of the Japan Society for Respiratory Endoscopy 41.6 (2019): 640-645.https://doi.org/10.18907/jjsre.41.6_640