Table of ContentsView AllTable of ContentsWhat Occurs in DIC?CausesSymptomsDiagnosisTreatmentPrognosisOngoing Care
Table of ContentsView All
View All
Table of Contents
What Occurs in DIC?
Causes
Symptoms
Diagnosis
Treatment
Prognosis
Ongoing Care
Disseminated intravascular coagulation(DIC) is a potentially life-threatening condition that develops when the delicate balance of factors involved in blood clotting is disrupted. As a result, a person with DIC easily clots, bleeds, or both.
This article explores what it means to have disseminated intravascular coagulation, including how it develops and its symptoms. It will also review the diagnosis and treatment of DIC.
Pramote Polyamate / Getty Images
Why Does Blood Overclot in Disseminated Intravascular Coagulation?
When a blood vessel in the body is injured, proteins andplatelets(disc-shaped cell fragments) work harmoniously to “plug” the wound site while simultaneously preventing blood loss.
The body’s ability to form this plug, orblood clot,is twofold, relying on both procoagulant (pro-clot) components and anticoagulant (anti-clot) components.
The procoagulant components create the blood clot, whereas the anticoagulant components limit the clot formation to preventthrombosis.
What Is Thrombosis?Thrombosis is when a clot obstructs the inside of the blood vessel. This blockage restricts blood flow to organs like the liver, brain, or kidneys.
What Is Thrombosis?
Thrombosis is when a clot obstructs the inside of the blood vessel. This blockage restricts blood flow to organs like the liver, brain, or kidneys.
In DIC, the procoagulant pathways are activated, while the anticoagulant pathways are simultaneously impaired.
Since the procoagulant and anticoagulant components are not in sync, blood clots form in small- to medium-size blood vessels throughout the body. These widespread clots impair blood flow, contributing to organ failure.
Excessive bleeding may also occur in DIC, especially if the condition progresses rapidly. Bleeding is due to the depletion or consumption of platelets and proteins used initially to help the blood clot form.
Stages of DICDIC occurs in the following two stages:Stage 1: The thrombotic phase (when blood clots obstruct small vessels)Stage 2: The bleeding phase (when clotting factors are all used up)A person with DIC may experience one or both stages.
Stages of DIC
DIC occurs in the following two stages:Stage 1: The thrombotic phase (when blood clots obstruct small vessels)Stage 2: The bleeding phase (when clotting factors are all used up)A person with DIC may experience one or both stages.
DIC occurs in the following two stages:
A person with DIC may experience one or both stages.
What Causes Disseminated Intravascular Coagulation?
DIC does not occur on its own. An underlying health condition always triggers it. DIC’s common causes—sometimes referred to as risk factors—aresepsisand cancer.
Sepsisoccurs when an infection triggers a severe whole-body reaction. The infection can be a virus, bacterium, fungus, or parasite.
DIC can also develop in individuals withcancer, including solid cancers (e.g.,lungorpancreatic cancer) and blood cancers (leukemia), especiallyacutepromyelocyticleukemia.
Other possible causes or risk factors for DIC include:
Emergency Disseminated Intravascular Coagulation Symptoms
The symptoms or manifestations of DIC includeblood clotsandbleeding, and their severity depends partially on whether the DIC is acute versus chronic.
Acute DICis more severe and develops very quickly, over hours to days. People with acute DIC are usually very sick and in the hospital.
Blood clotting and bleeding can occur in both acute and chronic DIC, although acute DIC is more likely to present with profuse bleeding due to the rapid consumption of clotting factors.
Seek Emergency Medical AttentionGo to the nearest emergency room or call 911 if you develop uncontrollable bleeding or potential symptoms of a blood clot like chest pain, extremity swelling, trouble breathing, or confusion.
Seek Emergency Medical Attention
Go to the nearest emergency room or call 911 if you develop uncontrollable bleeding or potential symptoms of a blood clot like chest pain, extremity swelling, trouble breathing, or confusion.
Blood Clots
The symptoms of blood clotting depend on the site(s) of the blockage. As an example, if a blood clot forms in the leg’s deep veins—calleddeep vein thrombosis, or DVT—leg swelling, warmth, redness, or tenderness develops.
Likewise, trouble breathing and chest pain can occur if a blood clot forms in the chest vessels near the lung or heart.
Thrombosis in small blood vessels that supply the liver or kidney may result in liver/kidney damage or failure. Astrokemay occur if a blood clot prevents blood from reaching the brain.
Signs and Symptoms of a Blood Clot
Bleeding
Symptoms of bleeding in DIC include:
Telling the Difference Between Petechiae and Purpura
Labs That Confirm Disseminated Intravascular Coagulation
There is no single test that can diagnose DIC. Instead, healthcare providers consider the results of several blood tests and the patient’s overall clinical picture.
DIC diagnostic blood tests include:
In DIC, the platelet count in DIC is typically reduced, and the PT and PTT tests are prolonged. Also, fibrinogen is usually low (as it’s depleted from excessive clotting), and D-dimer levels are elevated.
Disseminated Intravascular Coagulation Treatment
The cornerstone for treating DIC involves addressing the underlying cause.
For example, suppose a person has bacterial sepsis and resultant DIC. In that case, treatment is focused on killing the infection withantibioticsand providing support measures.
Such measures might include:
Secondly, treatments geared toward DIC are implemented. Depending on the clinical scenario, these might include:
Factors That Affect DIC Treatment Success
Scientific research suggests that DIC treatment success depends predominantly on how promptly the condition is diagnosed and the therapeutic strategies used to manage the condition.
Specific factors, like the platelet count or fibrinogen level, the severity of the DIC, and the underlying cause (e.g., sepsis, trauma, cancer), may also help predict treatment success, although more investigation is required.
What Is the Mortality (Death) Rate for DIC?In 2017, the 28-day mortality rate for critically ill people with DIC was found to be 36%, a slight decline from nearly 42% in 2010. Experts suspect the decline stems from advances in DIC therapies and changes in DIC-related care strategies.
What Is the Mortality (Death) Rate for DIC?
In 2017, the 28-day mortality rate for critically ill people with DIC was found to be 36%, a slight decline from nearly 42% in 2010. Experts suspect the decline stems from advances in DIC therapies and changes in DIC-related care strategies.
Morbidity vs. Mortality: What’s the Difference?
Ongoing DIC Treatment and Monitoring
Once the underlying health condition is treated, DIC can spontaneously resolve, sometimes within hours. That said, in many cases, DIC persists, and it’s not necessarily clear why.
Ongoing DIC requires close laboratory monitoring and care to restore platelet or clotting factor deficiencies or calm overactive clotting.
If you have been diagnosed with ongoing or chronic DIC, please take your medications as prescribed, report any new symptoms or side effects to your healthcare provider, and follow through with your blood tests.
Summary
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Papageorgiou C, Jourdi G, Adjambri E, et al.Disseminated intravascular coagulation: an update on pathogenesis, diagnosis, and therapeutic strategies.Clin Appl Thromb Hemost. 2018;24(9_suppl):8S-28S. doi:10.1177/1076029618806424
Palta S, Saroa R, Palta A.Overview of the coagulation system.Indian J Anaesth. 2014;58(5):515-23. doi:10.4103/0019-5049.144643
Levi M, Scully M.How I treat disseminated intravascular coagulation.Blood. 2018;131(8):845-854. doi:10.1182/blood-2017-10-804096
National Heart, Lung, and Blood Institute.Disseminated intravascular coagulation.
Rinaldi I, Sudaryo MK, Prihartono NA.Disseminated intravascular coagulation in sepsis and associated factors.J Clin Med. 2022;11(21):6480. doi:10.3390/jcm11216480
Sohal S, Thakur A, Zia A, Sous M, Trelles D.Disseminated intravascular coagulation and malignancy: a case report and literature review.Case Rep Oncol Med. 2020;2020:9147105. doi:10.1155/2020/9147105
Erez O, Mastrolia SA, Thachil J.Disseminated intravascular coagulation in pregnancy: insights in pathophysiology, diagnosis and management.Am J Obstet Gynecol. 2015;213(4):452-63. doi:10.1016/j.ajog.2015.03.054
Wada T, Shiraishi A, Gando S, et al.Disseminated intravascular coagulation immediately after trauma predicts a poor prognosis in severely injured patients.Sci Rep. 2021;11(1):11031. doi:10.1038/s41598-021-90492-0
Tomioka K, Aoki T, Matsuda K, et al.Clinical treatment of perioperative disseminated intravascular coagulation in patients who underwent gastrointestinal and hepato-biliary-pancreatic surgery.Am Surg. 2023;89(4):907-913. doi:10.1177/00031348211054702
Popescu NI, Lupu C, Lupu F.Disseminated intravascular coagulation and its immune mechanisms.Blood. 2022;139(13):1973-1986. doi:10.1182/blood.2020007208
Wada H, Matsumoto T, Yamashita Y.Diagnosis and treatment of disseminated intravascular coagulation (DIC) according to four DIC guidelines.J Intensive Care. 2014;2(1):15. doi:10.1186/2052-0492-2-15
Levi M.Diagnosis and treatment of disseminated intravascular coagulation.Int J Lab Hematol. 2014;36(3):228-36. doi:10.1111/ijlh.12221
Schwameis M, Buchtele N, Schober A, et al.Prognosis of overt disseminated intravascular coagulation in patients admitted to a medical emergency department.Eur J Emerg Med. 2017;24(5):340-346. doi:10.1097/MEJ.0000000000000361
Yamakawa K, Ohbe H, Taniguchi K, et al.Time trends of the outcomes and treatment options for disseminated intravascular coagulation: a nationwide observational study in Japan.JMA J. 2020;3(4):313-320. doi:10.31662/jmaj.2020-0013
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
