Symptoms of disseminated intravascular coagulation

Many people do not understand what disseminated intravascular coagulation is. In fact, it is not an independent disease, but a clinical syndrome. Common manifestations include bleeding in multiple parts of the body or symptoms of thrombosis and shock. Some may also cause damage to the functions of various organs.

1. Disseminated intravascular coagulation (DIC) is not an independent disease, but the final common pathway for many diseases to produce coagulation dysfunction during their progression. It is a clinical pathological syndrome. Because the coagulation mechanism in the blood is diffusely activated, it triggers extensive fibrin deposition in small blood vessels, leading to tissue and organ damage; on the other hand, the consumption of coagulation factors causes systemic bleeding tendency. These two contradictory manifestations exist simultaneously during the development of DIC and constitute unique clinical manifestations. Multiple organ dysfunction syndrome (MODS) is the leading cause of death in patients in whom DIC has already been initiated. There is no report on the incidence rate in China. The mortality rate of DIC is as high as 31% to 80%.

2. Clinical manifestations

Clinical manifestations are related to the underlying disease. Which proteolytic process (coagulation or fibrinolysis) is dominant in DIC will largely determine the characteristics of the clinical presentation. Those with coagulation as the main feature may only present as thromboembolic DIC; those with fibrinolysis as the main feature may develop into acute consumptive bleeding. A broad spectrum of clinical manifestations involving different types of DIC may also occur between the above.

1. Bleeding

Multiple sites of bleeding often indicate acute DIC. The most common symptoms are skin purpura, ecchymosis, and bleeding at puncture or injection sites. During or after surgery, the wound site continues to ooze blood and the blood does not coagulate.

2. Thromboembolism

Thrombosis in small arteries, capillaries or small veins causes microthrombosis in various organs, leading to organ hypoperfusion, ischemia or necrosis. Manifestations include hemorrhagic necrosis of the skin extremities; gangrene of fingers or toes.

3. Shock

Both the underlying disease of DIC and the DIC disease itself can induce shock.

4. Impairment of organ function

Important organs: ① Kidney damage rate 25% to 67%, manifested as hematuria, oliguria, or even anuria; ② Central nervous system dysfunction manifested as changes in consciousness, convulsions, or coma; ③ Respiratory function is affected, manifested as pulmonary hemorrhage and varying degrees of hypoxemia; ④ Digestive system manifested as gastrointestinal bleeding, etc.; ⑤ Liver dysfunction 22% to 57%, manifested as jaundice and liver failure.