Coagulation intravasculaire disséminée (CIVD)
De médecine.top
Révision datée du 19 janvier 2021 à 12:35 par Julien (discussion | contributions) (→EtiologieBr J Haematol 2009;145:24)
Etiologie[1]
- Sepsis and severe infection e.g. meningococcemia
- Trauma e.g. severe head injury
- Organ destruction e.g. pancreatitis, brain injury, burns
- Malignancy solid tumors, promyelocytic leukaemia
- Obstetric complications amniotic fluid embolism, placental abruption, pre-eclampsia
- Vascular abnormalities: large haemangiomata, vascular aneurysm
- Severe liver failure
- Toxic insults: snake bite, recreational drugs
- Immunological insults: ABO transfusion incompatibility, transplant rejection
- Purpura fulminans
Diagnostic
- Clinique et
- Biologique
Paramètre[2] | Valeur | Points |
---|---|---|
Thrombocytes | ≤ 100 G/l | 1 |
≤ 50 G/l | 2 | |
TP | < 60% | 1 |
< 45% | 2 | |
Fibrinogène | ≤ 1 g/l | 1 |
Marqueurs de la fibrinolyse | > 1000 ng/ml | 2 |
> 4000 ng/ml | 3 |
- DIC Score <5: not suggestive of overt DIC, may be non-overt DIC; repeat within next 1-2 days and manage clinically as appropriate.
- DIC Score ≥5 - compatible with overt DIC; treat for DIC as appropriate and repeat scoring daily.
Source: Critères ISTH pour CIVD https://www.mdcalc.com/isth-criteria-disseminated-intravascular-coagulation-dic
Traitement
- Correction de la cause sous-jacente
- Voir aussi Hémostase