Disseminated intravascular Coagulation

The CIVD or Disseminated Intravascular Coagulation (or syndrome of defibrination or coagulopathy of consumption) is a hemorrhagic syndrome characterized by the disappearance of the Fibrinogène of the circulating Sang.

The sudden appearance of factors of activation of the Thrombine causes the formation of deposits of Fibrine and the thrombotic obliteration of the small vessels. This reaction consumes the Fibrinogène, the factors V and VIII and the Plaquette S. blood thus becomes incoagulable and of the Hémorragie S occur. Occurs then a reactional phase with endogenous heparinemy and fibrinolyse.

This syndrome can be contemporary of a Accouchement or complication of a pathology of the Grossesse (ex: Pre-eclampsia, HELLP syndrome, etc), during a thoracic intervention of Surgery (ex: cardiac with extracorporal Circulation) or prostate sufferer, a Septicaemia, a shock, certain diseases of blood (ex: acute Leukemia myéloïde), a Cancer generalized, a Cirrhosis, an intoxication, etc…

Its gravity depends on the importance of the Hémorragie S and the Ischémie resulting from thromboses which undergo to them] S (kidneys, liver).

On the level of the biological and hematologic assessment, one observes a pertubation of the assessment of Coagulation, a deficit in Facteur of coagulation (fibrinogen, factors II, V and VIII), a Thrombopénie and an high rate of D-dimers.

The assumption of responsibility is only symptomatic, being based on the following therapeutic arsenal:

plate Transfusion, in order to maintain its level satisfactorily
contribution of fresh Plasma frozen, in order to bring the factors of inhibition of the coagulation which is lacking at the time of this pathology
Héparine if the treatment causes CIVD is ineffective or impossible
Antithrombine, a powerful inhibiter of coagulation, if one finds opposite a major CIVD
transfusion of globular bases in the event of associated Anémie

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