D65
DESCRIPTION
Complication of an underlying condition e.g. severe sepsis that is characterized by widespread activation of the clotting cascade leading to consumption of platelets and clotting factors with generalized bleeding.
DIAGNOSTIC CRITERIA
Investigations
- Prolonged INR and PTT.
- Thrombocytopaenia.
- Decreased fibrinogen.
- Increased D- Dimers.
- Repeat test for monitoring.
- Identify the cause.
MEDICINE MANAGEMENT
For low fibrinogen:
- Cryoprecipitate 1 unit/10kg.
For an abnormal INR or PTT:
- Fresh Frozen Plasma or Freeze Dried Plasma 15 mL/kg.
Active bleeding with low platelet:
- Apheresis platelet transfusion 5-10 mL/kg.
No bleeding with low platelets:
- No platelet transfusion.
REFERRAL
All unresponsive cases to a regional hospital.