Lab Test: Disseminated Intravascular Coagulation Screening, DIC Level
- Measurement of selected blood coagulation tests for the evaluation of disseminated intravascular coagulation (DIC), including acute DIC (patients demonstrate a coagulopathy), chronic DIC (chronic microembolic processes), and for patients who are at great risk for DIC (patients with sepsis or advanced cancer).
- Ovarian hyperstimulation syndrome - associated with abnormal coagulation studies, including a prolonged prothrombin time and a prolonged partial thromboplastin time
- Suspected and known disseminated intravascular coagulation (DIC) - the diagnosis of DIC should be based on clinical and global coagulation tests in addition to a screening assay, when available, to assess intravascular soluble fibrin formation or fibrin degradation products (FDP).
- The International Society on Thrombosis and Haemostasis recommends a 5-point algorithm system for diagnosing overt DIC. A score of greater than or equal to 5 is compatible with overt DIC, while a score of less than 5 is suggestive of , but not diagnostic for, non-overt (early) DIC. Daily testing is recommended for a score of 5 or above, and repeat testing in 1 to 2 days is recommended for a score of less than 5.
- Platelet count: greater than 100,000/microL=0 points; less than 100,000/microL = 1 point; less than 50,000/microL = 2 points
- Elevated fibrin-related marker (e.g., soluble fibrin monomers, FDP): no increase = 0 points; moderate increase = 2 points; strong increase = 3 points
- Prolonged prothrombin time (PT): less than 3 seconds = 0 points; greater than 3 seconds but less than 6 seconds = 1 point; greater than 6 seconds = 2 points.
- Fibrinogen: greater than 1 g/L = 0 points; less than 1 g/L = 1 point.
- Suspected and known toxic shock syndrome - DIC may develop in streptococcal toxic shock syndrome (TSS). Isolated aPTT prolongation has also been reported, suggesting that kallikrein-kinin system activation leading to bradykinin release may occur and contribute to several key features of this syndrome.
- This is a group of tests used to detect DIC, which many pathologic conditions can instigate or are associated with DIC. The more common conditions include bacterial septicemia, amniotic fluid embolism, retention of a dead fetus, malignant Neoplasia, liver cirrhosis, extensive surgery (especially on the prostate or liver), extracorporeal heart bypass, extensive trauma, severe burns, and transfusion reactions.
- In DIC, the entire clotting mechanism has been activated inappropriately, which results in significant systemic or localized intravascular formation of fibrin-based clots. Organ injury can occur as a result of intravascular clots, which cause microvascular occlusion in various organs.
- When a patient with a bleeding tendency is suspected of having DIC, a series of routinely performed laboratory tests are done (prothrombin time [PT], partial thromboplastin time [PTT], bleeding time, and platelet count). If results are abnormal, further testing should be performed.
- Protein C, Protein S - this test identifies patients who are deficient in protein C and/or S. This is part of an evaluation of hypercoagulation.
Indications & Uses
MESH Terms & Keywords