ICU Cases · Haematology & coagulation
The DIC in the septic shock
A short case on the DIC — the labs (the low platelets, the prolonged PT/APTT, the low fibrinogen, the raised D-dimer), the treat-the-cause, and the component therapy for the bleeding.
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Prompt
A septic patient develops a thrombocytopenia, a coagulopathy and a bleeding from the IV sites. Discuss the diagnosis and the management.
Presentation
A 55-year-old man in a severe septic shock from a perforated viscus develops the bleeding from the IV sites, the haematuria, and the thrombocytopenia of 40 x 10^9/L. The PT is 35 seconds, the APTT 65 seconds, the fibrinogen 0.9 g/L, the D-dimer markedly raised.[1]
References2ShowHide
- [1]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.
- [2]Marino PL The ICU Book. 4th edition, Lippincott Williams & Wilkins, 2014.