What does DIC stand for?
DIC stands for disseminated intravascular coagulation, and it is a paradoxical blood disorder. It is associated with many types of clinical disorders. What does it have to do with the brain, you may ask? This is often seen in patients that have a brain injury caused by acute trauma. An example of trauma where DIC can appear is after a car crash.
Why is it a paradoxical disorder?
DIC is paradoxical because when patients arrive in the hospital, their blood samples show low levels of platelets (known in lab terms as thrombocytopenia), but at the same time, there can be formations of micro- thrombi in the system. These thrombi are the cause of the low platelet count (they are often mistaken by a haematology analyzer as RBCs) and if they are not treated quickly, they can lead to organ failure via lack of oxygen. This condition is also exacerbated to the activation of fibrinolysis (breakdown of fibrin which forms blood clots) and consumption of the anti-clotting agents protein C, protein S and anti-thrombin III.
What are the clinical signs of DIC?
Often, DIC is not detected straight away because of the underlying trauma, but there are four key signs that can indicate the presence of the signature microthrombi associated with DIC:
- Skin necrosis (death of skin tissue due to capillaries under the skin dying)
- Renal insufficiency (due to kidney capillaries being blocked)
- Respiratory failure (due to lung capillaries being blocked)
- Multiple organ failure
How would DIC be detected in the haematology lab?
When the patient arrives in the hospital, a blood sample would be taken to the haematology (hematology) lab and the following tests and results would some up, as seen in the table below. It would then be treated by administering heparin.