Disseminated Intravascular Coagulation: A Comprehensive Review

Ott, Ashley

Publication

Disseminated Intravascular Coagulation: A Comprehensive Review

Ott, Ashley

Description

Disseminated intravascular coagulation (DIC) is a complex disorder that increases mortality in patients suffering from underlying disorders such as massive trauma, sepsis, postpartum hemorrhage, and SARS-CoV-2 infections. The pathology of DIC can be understood through Virchow’s Triad which highlights three characteristics that lead to hypercoagulability. Though the triad was traditionally used to only identify pro-thrombotic states, it can also be used to identify when hemorrhage could likely occur due to hypocoagulability. The triad includes (1) blood composition abnormalities, (2) changes in blood flow, and (3) endothelial damage. In DIC, severe endothelial damage leads to activation of coagulation, inflammation, and complement pathways ultimately producing excess thrombin. Excess thrombin production can lead to excess fibrin production leading to systemic, diffuse micro-thrombi formation thereby altering blood composition and impacting blood flow. The end result is often multiple organ dysfunction and failure, hemorrhage due to consumption of coagulation factors, or death if left untreated. While much progress has been made in identifying the many mechanisms behind the pathology of DIC, this condition is still often not recognized or treated early enough to save patients affected by it. Since early diagnosis is key to saving the lives of people with DIC, it is vital to spread awareness for this condition, learn of the current diagnostic and treatment options available, and discover where more research is needed in this field. This review will highlight key points regarding DIC and its pathology through the lens of Virchow’s triad as well as the current diagnostic and treatment options available to health care providers.