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[Therapy of consumption coagulopathies]
1Universitäts-Kinderklinik, Freiburg i.B.
Summary
Consumption coagulopathy, also known as disseminated intravascular coagulation, involves excessive clotting factor and platelet use. Early treatment of the underlying cause and circulatory support are crucial for managing this condition.
Area of Science:
- Hematology
- Pathophysiology
Context:
- Consumption coagulopathy and disseminated intravascular coagulation (DIC) are often used interchangeably.
- Both terms describe acquired blood clotting disturbances characterized by increased consumption of coagulation factors and platelets, leading to exhaustion of production sites.
Purpose:
- To elucidate the mechanisms and management of consumption coagulopathy/DIC.
- To emphasize the secondary nature of these disorders and the importance of treating the underlying cause.
Summary:
- Generalized activation of the hemostatic system initially causes hypercoagulability, followed by hypocoagulability and hemorrhagic diathesis.
- Microthrombi formation in the microcirculation is a key feature.
- Treatment focuses on addressing the underlying disease, restoring circulatory functions, and managing shock (hypothermia, acid-base/electrolyte imbalances, hypovolemia, anuria, uremia).
- Dextran can act as a plasma expander, correct hypercoagulability, and improve blood rheology.
Impact:
- Effective management relies on prompt and intensive treatment of the precipitating condition.
- Restoring circulatory function is key to resolving the coagulopathy.
- Anticoagulants or fibrinolytic drugs may be indicated if conservative measures fail to halt the consumptive process or restore microcirculation.