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Published byMitchell Thompson Modified over 8 years ago
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Management Control or elimination of the underlying cause Severe DIC: – Control of hemodynamic parameters – Respiratory support – Surgery Attempts to treat DIC without treatment of the causative disease are likely to fail
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Management of hemorrhagic symptoms DIC with marked thrombocytopenia and low levels of coagulation factors: – Replacement therapy – FFP Low levels of fibrinogen or brisk fibrinolysis: – Cryoprecipitate The replacement of 10 U of cryoprecipitate for every 2- 3 U of FFP is sufficient to correct the hemostasis Platelet concentrates at a dose of 1-2 U/10 kg body weight are sufficient for most DIC patients with severe thrombocytopenia
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Management Clotting factor concentrates are not recommended for control of bleeding in DIC because of the limited efficacy afforded by the replacement of single factors
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Replacement of coagulation or fibrinolysis inhibitors Low doses of continuous infusion heparin (5-10 U/kg/h) may be effective in patients with low- grade DIC associated with solid tumor or APL or in a setting with recognized thrombosis Antifibrinolytic drugs, EACA, Traxenamic acid – Prevent fibrin degradation by plasmin – But can increase risk for thrombosis (concomitant use of heparin is indicated) For patients with APL, chronic DIC associated with hemangiomas Protein C concentrates
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