ISTH Criteria for DIC (2001)
- Does patient have disorder associated with overt DIC? (if YES --> proceed)
- Platelets > 100 = 0, 50-100=1, <50=2
- FDPs (e.g. D-dimer): none=0, moderate=2, strong=3
- Prolonged PT beyond baseline: <3sec=0, 3-6sec=1, >6sec=2
- Fibrinogen: >100=0, <100=1
- Chronic DIC: evidence of fibrinolysis (e.g. elevated D-dimer) in the absence of another etiology w/ compatible underlying cause (often malignancy)
Posted 03/14/17 09:33:44 AM by Matthew Cummings
Rationale for of heparin products to treat DIC
- Thrombosis (thrombin generation exceeding that of plasmin) --> excessive degradation of fibrin and markedly low fibrinogen --> inability to clot --> bleeding
- Anti-coagulation --> reduce thrombotic burden --> reduce degradation of fibrin --> increase ability to clot
- Antifibrinolytic agents (TXA/Amicar) --> usually contraindicated --> blockade of the fibrinolytic system may increase the risk of thrombotic complications (limb/organ ischemia)
Posted 03/14/17 09:40:00 AM by Matthew Cummings
For further reading...
Posted 03/14/17 10:16:44 AM by Matthew Cummings
Created by Christopher Kelly
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