Disseminated Intravascular Coagulation (DIC)
Disseminated intravascular coagulation is a dynamic, acquired syndrome of systemic coagulation activation driven by another serious illness, causing microvascular thrombosis while consuming platelets and clotting factors; treat the trigger first and support bleeding selectively.
Definition
Disseminated intravascular coagulation is an acquired syndrome of systemic intravascular coagulation activation arising from and driven by an underlying disorder. It causes intravascular fibrin formation and microvascular thrombosis with consumption of platelets and coagulation factors, producing variable bleeding, thrombosis and organ dysfunction. Diagnosis requires clinical context plus a compatible, changing laboratory profile.
First principles
Systemic coagulation activation creates both thrombosis and bleeding
A severe systemic trigger activates thrombin generation and fibrin formation throughout the microcirculation. Microvascular thrombosis can impair organ perfusion, while continuing consumption of platelets and coagulation factors leaves the patient unable to achieve haemostasis at sites of injury. The clinical phenotype may therefore be predominantly bleeding, predominantly thrombotic, or mixed.
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