Type of test Blood

Normal findings

No evidence of DIC

Test explanation and related physiology

This is a group of tests used to detect disseminated intra vascular coagulation (DIC). Many pathologic conditions can instigate or are associated with DIC. The more common ones include bacterial septicemia, amniotic fluid embolism, retention of a dead fetus, malignant neoplasia, liver cirrhosis, extensive surgery (especially on the liver), post–extracorporeal heart bypass, extensive trauma, severe burns, and transfusion reactions.

In DIC, the entire clotting mechanism is inappropriately triggered. This results in significant systemic or localized intravascular formation of fibrin clots. The consequences of this futile clotting are small blood vessel occlusion and excessive bleeding caused by consumption of the platelets and clotting factors that have been used in intravascular clotting. The fibrinolytic system is also activated to break down the clot formation and the fibrin involved in the intravascular coagulation. This fibrinolysis results in the formation of fibrin degradation products (FDPs), which by themselves act as anticoagulants; these FDPs serve only to enhance the bleeding tendency.

Organ injury can occur as a result of the intravascular clots, which cause microvascular occlusion in various organs. This may cause serious anoxic injury in affected organs. Also, red blood cells passing through partly plugged vessels are injured and subsequently hemolyzed. The result may be ongoing hemolytic anemia. Figure 1 summarizes DIC pathophysiology and effects.

Fig1. Pathology of disseminated intravascular coagulation (DIC), which may result in bleeding tendency, organ ischemia, and hemolytic anemia. FDP, Fibrin degradation product; RBC, red blood cell.

When a patient with a bleeding tendency is suspected of having DIC, a series of readily performed laboratory tests should be conducted (Table 1). These tests are discussed separately in this book.

Table1. Disseminated intravascular coagulation screening tests

Abnormal findings

- Disseminated intravascular coagulation

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