4.3 Disseminated Intravascular Coagulation

• What is the condition called when the clotting mechanism is activated in widespread areas of circulation?

  Disseminated intravascular coagulation
• What often causes disseminated intravascular coagulation?

  Large amounts of traumatized or dying tissue
• What does traumatized tissue release into the blood that contributes to disseminated intravascular coagulation?

  Tissue factor
• How do the clots formed in disseminated intravascular coagulation typically present?

  Small but numerous, plugging blood vessels
• In which patients does disseminated intravascular coagulation occur especially?

  Patients with widespread septicemia
• What activates the clotting mechanisms in cases of septicemia?

  Circulating bacteria or bacterial toxins
• What is the effect of plugging small peripheral blood vessels in disseminated intravascular coagulation?

  Diminished delivery of oxygen and nutrients
• What condition can be exacerbated by diminished delivery of oxygen and nutrients?

  Circulatory shock
• What percentage of patients with septicemic shock are likely to be lethal?

  85 percent or more
• What peculiar effect can occur in patients with disseminated intravascular coagulation?

  Patients may begin to bleed
• Why do patients with disseminated intravascular coagulation experience bleeding?

  Too few procoagulants remain for hemostasis
• How does widespread clotting affect clotting factors in the blood?

  Removes many clotting factors from circulation