Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
27 Cards in this Set
- Front
- Back
|
Basic description of DIC |
Overstimulation of the clotting cascade - then the clotting factors are all used up - then the bleeding starts
|
|
|
How long does it take a normal clot to lyse?
|
7-10 days
In DIC, clot lyses right away as soon as its made |
|
|
What is the end result of a clot lysing
|
Split fibrin products
|
|
|
How do split fibrin products contribute to bleeding?
|
They are anticoagulant
|
|
|
Intrinsic causes of DIC |
ARDS, hypoperfusion, sepsis
|
|
|
Fibrinogen trends in DIC
|
Decreased, because used up to make clots
Fibrinogen is converted to fibrin to make a clot |
|
|
PT/PTT trends in DIC
|
Increased - because taking longer to clot as blood becomes more anticoagulated
|
|
|
D-dimer trends in DIC
|
Increases - it is essentially a fibrin split product
|
|
|
Platelets and DIC |
Thrombocytopenia because get used up in microclots, same as the clotting factors
|
|
|
PT in DIC
|
>40 sec
|
|
|
aPTT in DIC |
>70 sec
|
|
|
Thrombin time
|
>15 sec
|
|
|
Fibrinogen level
|
Less than 200
|
|
|
Clotting factor depletion |
I, V, VIII low, consider them the limiting reagents
|
|
|
Heparin use for DIC
|
Used when other treatments fail
Prevents clotting in the microvasculature - which is the biggest problem in DIC, not hemorrhage |
|
|
Contraindications to heparin in DIC
|
Hemorrhage, hepatic failure DIC, recent surgical procedures
|
|
|
Antithrombin III
|
Inhibits the action of thrombin
|
|
|
FFP
|
Contains all clotting factors
|
|
|
Cryoprecipitate
|
Factors VIII, XIII and fibrinogen
|
|
|
Desmopressin
|
Improves platelet function when platelet dysfunction is caused by aspirin or NSAIDs
|
|
|
Vitamin K
|
Needed for liver production of clotting factors - won't do any good if liver is shot
|
|
|
Heparin action according to Gasparis
|
Prevents the conversion of prothrombin to thrombin
Inactivates existing thrombin Prevents conversion of fibrinogen to fibrin |
|
|
Why not give clotting factors before heparin?
|
The body will make immediate clots that will immediately lyse
Have to stop the clotting first, and then address the lysing |
|
|
HIT
|
Anti-thrombin III not present, so heparin causes blood to clot instead of anticoagulating
|
|
|
Anticoagulant used for HIT positive people
|
Argatroban
|
|
|
T cells vs B cells
|
T cells - army - looks for viruses and non-self in the tissue
B cells - navy - looks for foreigns in the blood |
|
|
Therapeutic heparin drip indicators
|
When aPTT is 1.5-2 normal aPTT
About 25 seconds |
