DIC: what is it, symptoms
The concept of DIC is quite complicated for a person without medical education. So called one of the most common, but very dangerous violation in the system of hemostasis — blood clotting. This disease quite a lot of synonyms it is also called hypercoagulability or thrombo-haemorrhagic syndrome, coagulopathy of consumption and the syndrome of defibrinate.
DIC: what is it?
We will understand more with the term itself. Explanation, what is the DIC, there are several. Primarily, the disease is secondary (that is, develops on the background of any other problems), arises from the systematic long-term stimulation of the system of blood clotting. The disease has a phase current, that is, first she aktiviziruyutsya, and then gradually increases in parallel with the depletion of all links in the chain of hemostasis. In the most severe cases, blood can actually completely lose the ability to fold, which threatens the loss of control over even slight bleeding and severe generalized hemorrhagic syndrome.
When DIC doctors notice the progression of disseminated intravascular coagulation with numerous and widespread development of small blood clots and aggregates it formed elements (erythrocytes, platelets and leukocytes). This worsens the rheological characteristics (the density, the ability of the blood to flow normally through the vessels), inhibit the circulation of fluid in the organs and tissues. This leads to ischemic damage of certain fields, and subsequently to multiple organ failures.
Causes of DIC
The root cause of the disease, a massive release from certain tissues tromboplasticheskoy substances. However, in some cases, however, develops this problem?
The mechanism of development of DIC is very complex, with some pathologies it is necessary, «waiting» primary disease, in others it may develop, but may not appear at all.
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La problem with coagulation must be a factor that launched the trigger. In this case, it can be diverse injuries, surgery, shocks, etc. first and foremost, the development of DIC syndrome threatening generalized septic or infectious pathology, including those cases in childbirth, abortion or long-term catheterization of blood vessels. After septic shock is definitely developing a problem with hemostasis. In newborns, DIC is most often associated with consequences of infectious lesions.
DIC must «accompany» any shocks (traumatic, anaphylactic, burn, etc.). The longer and heavier the shock, the more problematic it will be to progress the pathology of clotting of blood. Cause of DIC can be any major trauma or surgery (especially for operations in Oncology, intravascular pathologies, etc.), as well as bleeding, frequent blood transfusions or collapse (sudden drop in blood pressure).
Often the disease is associated with acute intravascular hemolysis (the so-called destruction of certain cells within arteries, veins, capillaries or other vessels). The same applies to incompatible blood transfusions (when the blood group is not suitable to the recipient via the group membership). Often DIC-syndrome is found in obstetrics or during pregnancy. In this case we are talking about a previa or premature detachment of the placenta, occlusion of uterine vessels amniotic fluid, intrauterine fetal death. Pathology data provoke DIC 20 – 35% of cases.
Chronic DIC can occur completely asymptomatic. For understanding the mechanism of development of acute form of the disease, you must first deal with the phases of the course of disease. The first stage occurs hypercoagulability. This stage is accompanied by signs of a thrombohemorrhagic syndrome, reduction of the volume circulating through the vessels of blood (hypovolemia), metabolic disorders.
The second phase, unlike the first stage, is characterized by anticoagulation and is accompanied by multiple organ damage, blockade of microcirculatory system of parenchymatous organs, and hemorrhagic syndrome. Diagnosis at this stage shows a moderate decrease in platelet count, the ethanol test shows very positive results.
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The third stage is called the «consumption phase», and parallel aktiviziruyutsya local fibrinolysis. Loose clots in the site of bleeding in only 15 – 20 minutes to dissolve 50%. Develops multi-organ failure, severe metabolic disorders, hemorrhages in organs, massive bleeding, hematoma, etc. the Number of platelets is reduced and coagulation time of the blood increases. The forecast recovery in the third phase of the disease is questionable.
Generalized fibrinolysis — the so-called fourth and last stage of DIC. The blood in the capillaries ceases clotting, register parenchymal bleeding, presence of blood in the urine, terminal changes in many organs and systems. This stage usually ends in death.
In children, the DIC, if it is the result of severe pathology, 30 – 50% of cases ends tragically. That is why it is important to consult a doctor and start therapy. Do not self-medicate, it is dangerous for your health!