Question

Disseminated intravascular coagulation: Treatment.

Hint:

The treatment of DIC is multifaceted, with a focus on managing the underlying cause and providing supportive care to prevent complications such as bleeding and organ failure.

Answer 1

Step 1: General Approach to Treatment of DIC.
Treatment of DIC focuses on managing the underlying cause, controlling bleeding, and supporting organ function.
Step 2: Management of Underlying Cause.
(1) Infections: Appropriate antibiotics or antiviral therapy should be started immediately. In cases of sepsis, early source control (e.g., drainage of abscesses) is crucial.
(2) Obstetric Causes: Management of obstetric emergencies like placental abruption, amniotic fluid embolism, or eclampsia is essential.
(3) Malignancy: Treating the underlying malignancy, such as chemotherapy or surgery for tumor resection, is important.
Step 3: Supportive Treatment.
(1) Blood Product Replacement: Transfusions of fresh frozen plasma (FFP), platelets, and cryoprecipitate to replace consumed clotting factors and restore normal blood clotting.
(2) Antithrombotic Therapy: In some cases, heparin may be used to prevent further clotting, especially in patients with thrombotic manifestations. However, heparin use is controversial and must be carefully monitored, as it can exacerbate bleeding in some patients.
(3) Renal Support: In cases of renal failure, dialysis may be necessary.
(4) Organ Support: Intensive care support to manage multi-organ dysfunction, including respiratory support (e.g., mechanical ventilation) and circulatory support (e.g., vasopressors for hypotension).
Step 4: Monitoring and Follow-Up.
Frequent monitoring of coagulation parameters, platelet counts, and clinical status is necessary to adjust treatment and prevent complications.