How does disseminated intravascular coagulation (DIC) work?

[RNN7]

How does desseminated intravascular coagulation work? Can someone explain? I'm very confused about this. Patients with DIC gets clotting or bleeding? And how do people get DIC? Help!!! ?

[NRSKarenRN, BSN, RN]

NIH:What Is Disseminated Intravascular Coagulation?

Medscape: Disseminated Intravascular Coagulation

Lab test online: Understanding DIC

[Alex Egan, LPN, EMT-B]

Disseminated intravascular coagulation (DIC) involves abnormal, excessive generation of thrombin and fibrin in the circulating blood. During the process, increased platelet aggregation and coagulation factor consumption occur. DIC that evolves slowly (over weeks or months) causes primarily venous thrombotic and embolic manifestations; DIC that evolves rapidly (over hours or days) causes primarily bleeding. Severe, rapidly evolving DIC is diagnosed by demonstrating thrombocytopenia, an elevated PTT and PT, increased levels of plasma d-dimer (or serum fibrin degradation products), and a decreasing plasma fibrinogen level. Treatment includes correction of the cause and replacement of platelets, coagulation factors (in fresh frozen plasma), and fibrinogen (in cryoprecipitate) to control severe bleeding. Heparin is used as therapy (or prophylaxis) in patients with slowly evolving DIC who have (or are at risk of) venous thromboembolism.

It's from the Merk Manuel This is what made DIC click in my head, and make sense.

[sandytoes]

To add to PP, the way I understand it, the bleeding happens because all of the little clots have used up the circulating platelets and clotting factors = bleeding out.

[RNN7]

So patients usually have many clots in the body in early stage, is that correct?

[Esme12, ASN, BSN, RN]

For the most part...that is right....Disseminated intravascular coagulation (DIC) begins with excessive clotting. The excessive clotting is usually stimulated by a substance that enters the blood as part of a disease (such as an infection or certain cancers) or as a complication of childbirth, retention of a dead fetus, or surgery. It is also a complication of heparin use. As the clotting factors and platelets are depleted, excessive bleeding occurs.

[RNN7]

That's more clear now. Thank you so much!