DIC in newborns. DIC syndrome in newborns

DIC syndrome is a severe pathological blood disease. The mechanisms of disease development are as follows:

• stimulation of platelet function;
• stimulation of coagulative properties

As a result of this process, the following changes occur:

• increased thrombin synthesis;
• blood clot synthesis

Small clots form and interfere with blood circulation. Thrombocytopenia is a pathology that occurs due to a decrease in coagulation factors.

In addition to thrombocytopenia, the following symptoms occur:

• the phenomenon of fibrinolysis;
• severe hemorrhagic syndrome

A pathological severe condition that requires emergency intervention - DIC - syndrome. Mortality rate is up to sixty-five percent.

Etiology of DIC syndrome

This pathology is a consequence of other diseases. The etiology of the disease is as follows:

• infections;
• purulent diseases;
• artificial termination of pregnancy;
• catheterization process;
• injuries to the walls of blood vessels;
• mechanical damage to organs;
• consequence of surgery;
• phenomenon of vascular prosthetics

Additional causes of the disease:

• state of shock;
• gynecological diseases;
• pathology of pregnancy;
• tumor;
• malignant neoplasms;
• the phenomenon of hemolysis;
• acute course of hemolysis;
• autoimmune pathologies;
• medicines;
• drugs;
• toxic pathologies

Shock conditions include:

• anaphylactic shock;
• septic shock;
• cardiogenic shock;
• traumatic shock;
• hemorrhagic shock

Gynecological diseases include:

• amniotic fluid embolism;
• process of separation of the placenta;
• placenta previa;
• placental abruption;
• operative delivery

Malignant neoplasms of the following types:

• pulmonary system;
• prostate pathology

Immune pathologies of the following nature:

• hemorrhagic vasculitis;
• glomerulonephritis;
• systemic lupus

A common cause of this disease is generalized septicemia.

DIC - syndrome - symptoms

The clinic indicator is the main cause of the disease. The main way the disease arises is through shock situations. Symptoms of the disease in the chronic stage are as follows:

• minor bleeding;
• hypovolemia;
• dystrophy;
• metabolic disorders

Symptoms of DIC syndrome in the acute stage are as follows:

• phenomenon of increased coagulation;
• decreased coagulation;
• bleeding is intense;
• cardiogenic shock

The provision of medical care influences the manifestation of this disease. The necessary treatment is selected. This disease progresses in the following cases:

• injuries;
• lack of relief of hypovolemia;
• insufficient blood transfusion

DIC is a syndrome that can be variable in nature. In this case, this process is facilitated by:

• pancreas pathology;

Signs of hemocoagulative shock are as follows:

• impaired blood flow;
• oxygen starvation;
• kidney failure;
• liver failure

Death occurs in most percent of cases. The therapeutic effect is difficult to achieve. A severe condition occurs in patients in the following cases:

• diagnosis of the disease is untimely;
• untimely treatment with medications

Bleeding in this disease is profuse. The provocateur of hemorrhagic shock of a generalized type is a pathology of the hemostatic system. The intensity of bleeding varies; with gynecological diseases, uterine bleeding develops.

Treatment for the disease is as follows:

• hemostatic therapy;
• restoration of uterine tone;
• therapy for stomach ulcers

Signs of generalized hemorrhagic syndrome are:

• skin bruising;
• hemorrhages;
• cough;
• sputum;
• nosebleeds;
• sweating blood

Hemorrhages occur in the following areas:

• pulmonary system;
• brain;
• spinal cord;
• adrenal region;
• uterus

Sweating of blood affects the following system organs:

• pericardial system;
• abdomen;
• pleural cavity

Acute posthemorrhagic shock occurs with intense bleeding. In this case, emergency treatment is necessary. DIC, a chronic syndrome, is characterized as follows:

• presence of bleeding;
• permanent anemia;

For anemia, transfusion must be used. A mass transfusion of red blood cells is performed. As a result of disruption of the blood circulation process, organ function is affected. If the respiratory function of DIC is impaired, the syndrome is severe.

Signs of this condition are:

• breathing problems;
• sputum;
• acrocyanosis

Pulmonary edema is aggravated by transfusion of solutions. These solutions include:

• sodium;
• albumen

In case of shock to the pulmonary system, the following therapy is required:

• mechanical ventilation event;
• diuretics

The kidney system is also affected in this disease. In this case, the following symptoms arise:

• accumulation of proteins in the urine;
• accumulation of red blood cells in the urine;
• impaired urination

With liver pathology, the following symptoms occur:

• kidney failure;
• liver failure;
• abdominal pain;
• icteric syndrome

When treated with hormones, the following symptoms occur:

• hemorrhages;
• bleeding;
• intoxication

Intoxication is a consequence of functional intestinal disorders. Signs of impaired blood circulation in the brain:

• headache;
• signs of meningitis;
• dizziness;
• impaired consciousness

Signs of septic lesions are as follows:

• platelet formation;
• electrolyte disturbances;
• dehydration process;
• adrenal insufficiency

DIC – syndrome – stages

There are signs for each stage. The initial stage is the hypercoagulative stage. Signs of the hypercoagulable stage:

• intravascular aggregation;
• various blood clots;
• fatal outcome

The second stage of DIC syndrome is a stage accompanied by a decrease in platelets. Their aggregation is increased. Signs of this stage:

• phagocytosis;
• microclot lysis process

The third stage of the disease is the fibrinolytic stage. Signs of the third stage of the disease:

• restoration of blood circulation;
• damage to clotting factors

The fourth stage of DIC syndrome is the recovery stage. The signs of this stage are as follows:

• necrosis;
• dystrophy;
• restoration of tissue function

Multiple organ failure is a consequence of the lack of proper treatment. The use of medications is the basis of treatment.

In pregnant women, DIC syndrome

The process of impaired hemostasis occurs during pregnancy. Gynecological pathologies are important. Causes of death as a result of this disease:

• bleeding is intense;
• development of blood clots

Periods of development of DIC syndrome:

• stage of pregnancy;
• period after childbirth;
• newborn period

Forms of development of this disease:

• lightning stage of damage;
• death;
• sluggish defeat;

Signs of chronic disease:

• pregnancy status;
• cardiac pathology;
• urinary system disorder

Acute blood loss is a provoking factor of DIC syndrome. The cause is intense uterine bleeding.

Possible etiological signs of the disease:

• infections;
• inflammatory phenomena;
• embolism;
• placental abruption;
• inflammation of the endometrium;
• purulent lesion

The duration of the hypercoagulable stage is up to three days. Signs of this stage:

• redness of the skin;
• cardiopalmus

Signs of the hypocoagulable stage of the disease:

• uterine bleeding;
• nose bleed;
• presence of hemorrhages;
• presence of rashes;

There are various sources of bleeding. Diagnosis of the disease in pregnant women:

• use of coagulogram;
• laboratory methods

Therapeutic therapy includes:

• drug treatment;
• non-pharmacological means

Hospitalization of a pregnant woman is necessary. A pregnant woman is hospitalized in a hospital.

The child has DIC syndrome

The risk group is children, especially the neonatal period. Children may have the following symptoms:

• infections inside the womb;
• viruses;
• low body temperature;
• oxygen starvation;
• signs of acidosis

The cause of the disease in children is cardiac shock. Processes influencing DIC syndrome:

• thrombin synthesis;
• vascular damage;
• increased coagulation;
• blood clot formation;
• oxygen starvation;
• reduction of coagulation factors;
• decrease in platelets;
• impaired hemostasis process

The clinic is a reflection of the stage of the disease. The underlying disease matters. Possible signs of the disease:

• acrocyanosis;
• increased breathing;
• decreased blood pressure;
• urinary disturbance;
• liver enlargement;
• spleen enlargement

In the coagulopathic phase, the skin turns blue. The development of hemorrhagic shock is possible. Bleeding in the brain is a dangerous consequence of this condition.

Mortality is increasing. With assistance, the outcome of the disease is favorable. The recovery phase occurs with proper treatment. The main focus of therapy in children is to exclude the underlying cause.

Blood transfusions are used. To do this, use the following means:

• plasma solution;
• pentoxifylline solution;
• drug dopamine

Treatment of the coagulopathy phase in a child:

• replacement transfusion;
• platelet transfusion;
• heparin

Heparin is administered under the control of a coagulogram. Treatment during the recovery period is symptomatic. Thrombolytic agents are used in this case.

Diagnosis of DIC syndrome

The following diseases with impaired hemostasis are distinguished:

• sepsis;
• burn;
• bites

Diagnosis is complicated in the following pathologies:

• leukemia signs;
• lupus erythematosus;

Testing is used in this case. Methods for diagnosing this disease:

• lab tests;
• instrumental method;
• blood clot analysis;
• calculation of prothrombin time;
• paracoagulation tests

For rational treatment, the following diagnostic methods are used:

• antithrombin assay;
• plasma research;
• sensitivity determination

Basic diagnostics of the following type:

• determine hematocrit;
• level of hypoxemia;
• electrolyte level;
• biochemistry

Chronic DIC syndrome is diagnosed at the terminal stage. The signs of chronic DIC syndrome are as follows:

• oncological diseases;
• cardiac congestion;
• myeloproliferative diseases

Signs of myeloproliferative diseases:

• increased blood viscosity;
• increased hematocrit;
• infiltrative foci

A severe degree of DIC syndrome occurs during chronic hemodialysis.

Treatment of DIC syndrome

DIC is a syndrome treated by rheumatologists. The therapy room is intensive. The mortality rate is up to thirty percent. The basis of therapy for this disease is the exclusion of provoking factors.

Therapy for this disease is antibacterial, since purulent processes are possible. Sensitivity to drugs is determined. There are indications for the use of antibacterial agents:

• criminal abortions;
• discharge of amniotic fluid;
• intoxication

Intoxication symptoms are as follows:

• hectic fever;
• meningitis;
• lung damage

The following means are also used:

• intravenous infusions;
• antiprotease agents

The effect of these drugs is as follows:

• reduction of intoxication;
• reduction of the destructive process

Antishock therapy is required to reduce shock states. Drugs used to reduce shock conditions:

• drug reopolyglucin;
• glucocorticosteroids

Medicines to improve blood circulation:

• adrenoblockers;
• phentolamine;
• drug trental

Heparin is used only in the presence of laboratory control. A large dosage of heparin is used in combination with antiproteases. Heparin is not used for heavy bleeding.

Indications for discontinuation of heparin:

• collapse;
• decreased blood pressure;
• thrombocytopenic syndrome

The effect of using transfusions:

• stopping the destruction process;
• coagulation correction;
• increasing protective properties

Drugs used in the treatment of the hypercoagulable phase:

• saline solution;
• albumins

Transfusion is also performed. Indications for red blood cell transfusion:

• heavy bleeding

Plasmapheresis is used for chronic disease. Consequences of plasmapheresis:

• protein removal;
• clotting factor is activated

Complex treatment with the following drugs is effective:

• dipyridamole;
• trental

The indication for surgical treatment is the presence of a source of bleeding. Methods of surgical treatment:

• gastrofibroscope method;
• hemostatic agents

DIC syndrome(disseminated intravascular coagulation, consumption coagulopathy, thrombohemorrhagic syndrome) - impaired blood coagulation due to massive release of thromboplastic substances from tissues.

It may be asymptomatic, or in the form of acutely developed coagulopathy. Often found in various obstetric pathologies, various types of shock, severe injuries, and bacterial sepsis.

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  There are 3 main types of disease progression.

  There are also quite a large number of classifications according to the stages of development of the process.

  According to M.S. Machabeli, there are 4 stages.

  • Stage I - hypercoagulation
  • Stage II - consumption coagulopathy
  • Stage III - a sharp decrease in all procoagulants in the blood, up to the complete absence of fibrinogen.
  • Stage IV - recovery.

  According to Fedorova Z.D. et al. (1979), Baryshev B.A. (1981), the classification is as follows.

  • Stage I - hypercoagulation.
  • Stage II - hypocoagulation.
  • Stage III - hypocoagulation with generalized activation of fibrinolysis
  • Stage IV - complete non-coagulation of blood.

  Etiology

  Etiological forms of acute and subacute DIC syndrome

  1. Infectious-septic:
     • bacterial;
     • viral;
     • toxic shock (including during abortion).
  2. Traumatic and tissue destruction:
     • burn;
     • long-term compartment syndrome;
     • massive injuries;
     • with necrosis of tissues and organs (acute toxic liver dystrophy, necrotizing pancreatitis, acute myocardial infarction, etc.);
     • with acute intravascular hemolysis, including transfusions of incompatible blood;
     • during traumatic operations;
     • with massive blood transfusions;
     • for hemoblastoses, especially acute promyelocytic leukemia;
     • in acute radiation sickness.
  3. Obstetrics and gynecology:
     • with embolism by amniotic fluid (especially infected);
     • with early abruption and placenta previa;
     • with atony and massage of the uterus;
     • with intrauterine death of the fetus and its retention;
     • for preeclampsia and eclampsia.
  4. Shock (for all terminal conditions).
  5. During intensive chemotherapy.
  6. During organ transplantation.

  The causes of chronic (protracted) DIC syndrome are most often the following types of pathology:

  1. chroniosepsis, including prolonged septic endocarditis;
  2. chronic immune and immune complex diseases;
  3. chronic viral diseases (hepatitis, HIV, etc.);
  4. tumor processes (cancer, lymphomas, leukemia, etc.).

  Phases of DIC syndrome:

  • Phase I - hypercoagulation. The loss of coagulation factors during heavy bleeding leads to an increase in the time of clot formation and retraction, and an increase in the time of capillary bleeding. Laboratory indicators: decreased blood clotting time, thrombin time, positive ethanol test.
  • Phase II - hypocoagulation. During hemorrhagic shock in the phase of spasm of venules and arterioles (clinical manifestations: dehydration, pale and cold skin, signs of acute renal failure), a separation of plasma and formed elements develops in the capillaries - a “sludge” phenomenon. Aggregation of formed elements and enveloping them in fibrin are accompanied by the consumption of blood coagulation factors and activation of fibrinolysis. Laboratory indicators: moderate thrombocytopenia (up to 120×10 9 /l), thrombin time 60 s or more, sharply positive ethanol test.
  • Phase III - consumption with activation of local fibrinolysis. Afibrinogenemia in combination with pronounced activation of fibrinolysis. During this phase, loose blood clots at the site of bleeding are quickly (within 15-20 minutes) lysed by 50%. Laboratory indicators: increase in blood clotting time, thrombin time, decrease in platelets to 100×10 9 /l, rapid clot lysis.
  • Phase IV - generalized fibrinolysis. Capillary blood does not coagulate, parenchymal bleeding, petechial rashes on the skin and internal organs, hematuria, effusion in the synovial cavities and terminal changes in organs and systems are noted.

  Pathogenesis

  The main links in the pathogenesis of DIC syndrome

  1. Initial activation of the hemocoagulation cascade and platelets by endogenous factors: tissue thromboplastin, leukocyte proteases, tissue breakdown products, tumor procoagulants;
  2. Persistent thrombinemia with an increase in the level of its markers in the blood (RFMK and D-dimers);
  3. Depletion of the physiological anticoagulant system with a significant decrease in the plasma levels of antithrombin III, protein C, plasminogen and an increase in the level of thrombomodulin in the blood plasma;
  4. Systemic damage to the vascular endothelium and a decrease in its antithrombotic potential;
  5. Formation of microblood clots and blockade of microcirculation in target organs (brain, adrenal glands, kidneys, liver, stomach and intestines (multiple organ failure subsyndrome) with the development of dystrophic and destructive disorders in them).
  6. Activation of fibrinolysis in the area of ​​microcirculation blockade and depletion of its reserves in the general circulation;
  7. Consumption of hemocoagulation factors and thrombocytopenia (and - pathia) consumption, leading to systemic bleeding and terminal hypocoagulation up to complete blood incoagulation (hemorrhagic phase of the syndrome);
  8. Violation of the barrier function of the mucous membrane of the stomach and intestines with the transformation of aseptic DIC syndrome into septic;
  secondary severe endogenous intoxication.

  Clinical picture

  The clinical picture of DIC syndrome includes:

  • in the 1st stage - symptoms of the underlying disease and signs of thrombohemorrhagic syndrome (with a predominance of manifestations of generalized thrombosis), hypovolemia, metabolic disorders;
  • in the 2nd stage, signs of multiple organ damage and blockade of the microcirculation system of parenchymal organs, hemorrhagic syndrome (petechial purpuric type of bleeding) appear;
  • in the 3rd stage, these disorders are joined by signs of multiple organ failure (acute respiratory, cardiovascular, hepatic, renal, intestinal paresis) and metabolic disorders (hypokalemia, hypoproteinemia, mixed type metabolic syndrome (petechiae, hematomas, bleeding from the mucous membranes, massive gastrointestinal, pulmonary, intracranial and other bleeding, hemorrhages in vital organs);
  • in the 4th stage (with a favorable outcome), the main vital functions and hemostasis indicators gradually normalize.

  Diagnostics

  Blood coagulation and fibrinolysis disorders are diagnosed.

  EXPRESS DIAGNOSTICS OF HEMOSTASIS DISORDERS.

  Hypercoagulable phase of DIC syndrome
  If there is a disease or condition that can cause hypercoagulability syndrome, it is necessary to determine a number of laboratory parameters

  The development of the syndrome in a newborn is possible due to factors in intrauterine development or pathologies after birth or during childbirth.

  During puberty, the following factors contribute to the development of the disease:

  • placenta previa,
  • fetoplacental insufficiency,
  • death of one child during multiple pregnancy,
  • malignant neoplasms of the uterus with damage to its soft tissues,
  • severe gestosis in late pregnancy,
  • unreasonably prolonged stimulation of labor.

  Reasons for the development of DIC syndrome in the perinatal and neonatal period:

  • conflict Rh factor,
  • oxygen starvation,
  • premature birth,
  • infection during childbirth,
  • respiratory disorders,
  • birth injuries resulting in disorders of the central nervous system.

  Symptoms

  If a pregnant woman has DIC syndrome, with a 90% probability we can say that her baby will also have this blood flow problem.

  Immediately after birth, it is impossible to visually detect manifestations of the disease in a newborn. A prompt blood test is required, which will provide data on the composition of blood, plasma and the concentration of thromboplastin in it.

  The newborn also goes through all stages of development of the syndrome.

  • hypercoagulation - sticking together of blood cells,
  • hypocoagulation - excessive blood thinning,
  • fibrinolysis is the most critical stage with pronounced thrombocytopenia,
  • recovery - normalization of platelet levels in the blood.

  Diagnosis of DIC syndrome in a newborn

  In a baby, these stages develop rapidly. In the absence of timely diagnosis, the onset of the third stage becomes fatal for most infants, since the body itself cannot cope with the anomaly and multiple internal hemorrhages occur.

  An immediate response from specialists to abnormalities in a newborn’s hemostasis can save a little person from serious complications and tragic consequences.

  Complications

  The intrauterine development of DIC syndrome threatens pregnancy failure and premature birth.

  If the disease is detected immediately after birth and treated immediately, the prognosis is quite favorable.

  If the diagnosis is made late, then the probability of death of the baby is 30-50%.

  Treatment

  What can you do

  A young mother needs to be extremely attentive, strictly follow all medical recommendations, agree with the doctor’s treatment tactics and take the necessary medications. Only in agreement with specialists can the baby’s blood clotting be restored as quickly as possible and without side effects.

  Under no circumstances should you resort to traditional therapy. Her methods can only make the situation worse.

  A young mother needs to remain calm to avoid difficulties with lactation. After all, breast milk is the best immunomodulator during infancy, as well as an excellent sedative, but only if the mother’s mental state is good.

  What does a doctor do

  A group of specialists is working on the treatment of DIC syndrome in a newborn. They draw up an individual treatment plan for each specific case. Therapeutic tactics depend on the stage of the disease, its causes and the general condition of the newborn. In any case, doctors adhere to the following principles.

  • Immediate start of treatment after receiving the results of the blood test.
  • Surgical removal of the causes of DIC syndrome. First of all, therapy is aimed at removing intoxication from the child’s body and getting out of a state of shock.
  • Calculation of possible risks, on the basis of which methods of treatment and elimination of symptoms are selected.

  In any case, the treatment is complex. As a rule, therapy proceeds in several directions at once, which allow achieving a quick and good effect.

  • anti-shock measures,
  • maintaining the composition and volume of blood and plasma,
  • treatment of the underlying disease,
  • elimination of pathological abnormalities,
  • heparin therapy,
  • administration of medications,
  • restorative therapy with medications, vitamins and physiotherapy.

  Prevention

  Syndromic disruption of homeostasis is easier to prevent than to treat. To avoid childhood pathology, the expectant mother should begin to take care of her child even before conception. Of course, care should continue after birth. To prevent DIC syndrome in a newborn, it is necessary:

  • before pregnancy, identify pathological abnormalities in your body and eliminate them,
  • During pregnancy, visit a gynecologist, lead a healthy lifestyle, eat right, and protect yourself from negative influences. All this is done with the aim of normal pregnancy and fetal development.
  • with the onset of labor, call an ambulance or get to the maternity hospital on your own, do not give birth at home,
  • If necessary, after birth, immediately give consent to the treatment of the baby.

  The abbreviation DIC hides the name of a severe pathology - disseminated intravascular coagulation. Disease of the hematopoietic system is a complication of the underlying disease, but it is DIC syndrome in children that poses a particular danger because it causes problems with blood clotting.

  DIC syndrome in children is formed against the background of various diseases and is one of the most severe complications that causes the death of infants during the neonatal period. The figure reaches 36 – 50%.

  Most often it occurs in an acute or fulminant form, but a protracted, as well as latent (hidden) or worsening course is possible. Typical for children aged 1 – 4 years.

  Causes of development of DIC in newborns

  DIC syndrome in newborns can be caused by the following reasons:

  • damage to the “children's place”;
  • intrauterine death of one of the children during multiple pregnancy;
  • intrauterine infection;
  • condition of eclampsia and preeclampsia;
  • uterine rupture;
  • hydatidiform mole.

  Most often, the pathology is diagnosed in premature infants. The child’s blood contains insufficient amounts of procoagulants or anticoagulants, which causes increased bleeding.

  Symptoms

  The clinical picture of the condition is determined by the current stage of the pathology. The primary signs can be:

  1. Hypercoagulation stage. The symptoms of the leading disease become the main ones. Signs of impaired blood microcirculation are added - the appearance of a characteristic “marble” mesh on the skin, a decrease in body temperature, blue discoloration of the tips of the fingers and toes, an increase in the volume of the liver/spleen. The development of tachycardia, a drop in blood pressure, and a decrease in urination cannot be ruled out.
  2. Stage of thrombocytopathy and coagulopathy. Petechiae form on the surface of the skin, the surface of the mucous membranes becomes pale. Bleeding develops in the area where medications are injected. Vital organs - lungs, kidneys, brain - are involved in the pathological process. Internal hemorrhages cannot be ruled out.
  3. Recovery stage. In the case of treatment adequate to the condition, a decrease in pathological symptoms is observed. The affected organs are restored and begin to function normally.

  Features of DIC syndrome in newborns

  DIC syndrome in an infant can develop due to many diseases. The condition typically has a lightning-fast course, which practically excludes the possibility of using any treatment.

  Diagnosis in children

  At the first stage of DIC syndrome, diagnosis is based on the results of a laboratory study of blood composition. The development of pathology is indicated by:

  • a slight decrease (relative to the accepted norm) of blood clotting time;
  • drop in platelet count;
  • reduction of prothrombin time, APTT period (clot formation time);
  • increased levels of fibrogen and PDP (this is a sign of increasing intravascular coagulation);
  • positive result for ethanol test.

  Making a diagnosis when the second stage occurs is greatly simplified. Deviations from the norm are increasing. Signs of damage to internal organs are observed, in particular, there is an even greater decrease in the number of platelets and a deterioration in the condition of the vascular system.

  Therapeutic measures

  

  Treatment of the condition requires an integrated approach. There are several basic principles.

  1. Therapy for the acute form of DIC syndrome begins immediately after the collection of biomaterial for research.
  2. Measures to eliminate possible provoking factors should be carried out as soon as possible.
  3. During treatment, the doctor constantly evaluates the current clinical picture and takes into account the possible negative impact of the measures taken, which can cause an increase in the symptoms of DIC syndrome and cause profuse bleeding.

  The pathology treatment protocol includes statistics, classification of DIC, and data on drug interactions. It also consists of the following points:

  • elimination of the underlying disease;
  • anti-shock therapy, ensuring the required volume of circulating blood;
  • taking heparin;
  • jet infusion of fresh plasma;
  • patients receiving protease inhibitors and drugs from the antibradykin group;
  • the use of medications that stimulate blood microcirculation processes and reduce the loss of platelets from the general bloodstream;
  • maintaining hematocrit at 22% and above;
  • taking Contrikal for severe forms of hypocoagulation and bleeding;
  • performing local hemostasis;
  • plasmacytopheresis procedure (according to indications).

  Complications and prognosis

  Among the complications caused by DIC syndrome, it is worth highlighting.

  1. Impaired blood microcirculation up to the development of complete/partial blockade. Lung and kidney tissues are most often affected. As a result of thrombosis of small vessels of the brain, the development of ischemic stroke cannot be ruled out.
  2. Hemocoagulative shock. One of the most severe complications of the pathology. Has a bad prognosis.
  3. Hemorrhagic syndrome. Characterized by hemorrhages, different types of bleeding.
  4. Posthemorrhagic decrease in hemoglobin level. Anemia develops due to blood loss.

  The prognosis of the syndrome is variable and depends on several factors:

  • leading disease;
  • severity of hemostasis disorders;
  • time of therapy started.

  Acute DIC syndrome can lead to the death of the patient due to significant blood loss, the development of shock, disruption of the respiratory system and numerous internal hemorrhages.

  Treatment of DIC syndrome

  

  The success of therapy for the syndrome largely depends on at what stage of the condition the patient began receiving medications and procedures.

  Active intake of medications and other therapeutic measures are necessary when bleeding occurs and the functionality of internal organs is impaired. Patients are subject to mandatory hospitalization in the intensive care unit. If necessary, artificial ventilation of the lungs and anti-shock treatment are performed.

  In mild cases of DIC syndrome, the underlying disease is treated and hemodynamics and organ dysfunction are corrected.

  Treatment of acute DIC syndrome is based on urgent elimination of the provoking cause. For example, in case of obstetric pathology, an urgent delivery or removal of the uterus may be required; in case of septic complications, the patient is prescribed a course of antibiotics.

  To eliminate hypercoagulability syndrome, treatment with the following drugs is indicated:

  • anticoagulants (Heparin);
  • antiplatelet agents (Pentoxifylline, Dipyridamole);
  • fibrinolytics.

  Replacement therapy involves transfusions:

  • fresh plasma;
  • red blood cell/platelet mass (with a catastrophic decrease in hemoglobin/platelets);
  • cryoprecipitate (in the formation of myocardial dysfunction);
  • saline solution.

  In case of massive bleeding, drugs from the group of antifibrinolytics - aminocaproic acid, protease inhibitors - may be prescribed.

  Treatment of skin hemorrhages and open wounds uses hemostatic sponges and dressings with ethamsylate.

  According to indications the following are prescribed:

  • corticosteroids;
  • plasmapheresis;
  • oxygen therapy;
  • angioprotectors;
  • nootropic drugs.

  When renal failure develops, hemodialysis and hemodiafiltration are prescribed.