Disseminated intravascular coagulation physical examination: Difference between revisions
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Physical examination of patients with [[DIC]] is usually remarkable for the following:<ref name="pmid29021432">{{cite journal |vauthors=Miyashima Y, Iwamuro M, Shibata M, Miyabe Y, Kawai Y, Kaihara M, Mitogawa T, Harada M |title=Prediction of Disseminated Intravascular Coagulation by Liver Function Tests in Patients with Japanese Spotted Fever |journal=Intern. Med. |volume=57 |issue=2 |pages=197–202 |date=January 2018 |pmid=29021432 |pmc=5820036 |doi=10.2169/internalmedicine.8420-16 |url=}}</ref><ref name="pmid30198317">{{cite journal |vauthors=Iba T, Arakawa M, Ohchi Y, Arai T, Sato K, Wada H, Levy JH |title=Prediction of Early Death in Patients With Sepsis-Associated Coagulation Disorder Treated With Antithrombin Supplementation |journal=Clin. Appl. Thromb. Hemost. |volume= |issue= |pages=1076029618797474 |date=September 2018 |pmid=30198317 |doi=10.1177/1076029618797474 |url=}}</ref><ref name="pmid30189766">{{cite journal |vauthors=Kilicci C, Ozkaya E, Karakus R, Sanverdi I, Abide Yayla C, Bostanci Ergen E, Mutlu S |title=Early low molecular weight heparin for postpartum hemorrhage in women with pre-eclampsia. Is it effective to prevent consumptive coagulopathy? |journal=J. Matern. Fetal. Neonatal. Med. |volume= |issue= |pages=1–5 |date=September 2018 |pmid=30189766 |doi=10.1080/14767058.2018.1494708 |url=}}</ref><ref name="pmid30185500">{{cite journal |vauthors=McBride AM |title=Clinical Presentation and Treatment of Amniotic Fluid Embolism |journal=AACN Adv Crit Care |volume=29 |issue=3 |pages=336–342 |date=2018 |pmid=30185500 |doi=10.4037/aacnacc2018419 |url=}}</ref><ref name="pmid30184540">{{cite journal |vauthors=Judkins AJ, MacQueen BC, Christensen RD, Henry E, Snow GL, Bennett ST |title=Automated Quantification of Fragmented Red Blood Cells: Neonatal Reference Intervals and Clinical Disorders of Neonatal Intensive Care Unit Patients with High Values |journal=Neonatology |volume=115 |issue=1 |pages=5–12 |date=September 2018 |pmid=30184540 |doi=10.1159/000491626 |url=}}</ref> | Physical examination of patients with [[DIC]] is usually remarkable for the following:<ref name="pmid29021432">{{cite journal |vauthors=Miyashima Y, Iwamuro M, Shibata M, Miyabe Y, Kawai Y, Kaihara M, Mitogawa T, Harada M |title=Prediction of Disseminated Intravascular Coagulation by Liver Function Tests in Patients with Japanese Spotted Fever |journal=Intern. Med. |volume=57 |issue=2 |pages=197–202 |date=January 2018 |pmid=29021432 |pmc=5820036 |doi=10.2169/internalmedicine.8420-16 |url=}}</ref><ref name="pmid30198317">{{cite journal |vauthors=Iba T, Arakawa M, Ohchi Y, Arai T, Sato K, Wada H, Levy JH |title=Prediction of Early Death in Patients With Sepsis-Associated Coagulation Disorder Treated With Antithrombin Supplementation |journal=Clin. Appl. Thromb. Hemost. |volume= |issue= |pages=1076029618797474 |date=September 2018 |pmid=30198317 |doi=10.1177/1076029618797474 |url=}}</ref><ref name="pmid30189766">{{cite journal |vauthors=Kilicci C, Ozkaya E, Karakus R, Sanverdi I, Abide Yayla C, Bostanci Ergen E, Mutlu S |title=Early low molecular weight heparin for postpartum hemorrhage in women with pre-eclampsia. Is it effective to prevent consumptive coagulopathy? |journal=J. Matern. Fetal. Neonatal. Med. |volume= |issue= |pages=1–5 |date=September 2018 |pmid=30189766 |doi=10.1080/14767058.2018.1494708 |url=}}</ref><ref name="pmid30185500">{{cite journal |vauthors=McBride AM |title=Clinical Presentation and Treatment of Amniotic Fluid Embolism |journal=AACN Adv Crit Care |volume=29 |issue=3 |pages=336–342 |date=2018 |pmid=30185500 |doi=10.4037/aacnacc2018419 |url=}}</ref><ref name="pmid30184540">{{cite journal |vauthors=Judkins AJ, MacQueen BC, Christensen RD, Henry E, Snow GL, Bennett ST |title=Automated Quantification of Fragmented Red Blood Cells: Neonatal Reference Intervals and Clinical Disorders of Neonatal Intensive Care Unit Patients with High Values |journal=Neonatology |volume=115 |issue=1 |pages=5–12 |date=September 2018 |pmid=30184540 |doi=10.1159/000491626 |url=}}</ref> | ||
Hemtological: | === Hemtological: === | ||
* Signs of spontaneous and life-threatening [[hemorrhage]] | * Signs of spontaneous and life-threatening [[hemorrhage]] | ||
* Signs of subacute [[bleeding]] | * Signs of subacute [[bleeding]] | ||
* Signs of diffuse or localized [[thrombosis]] | * Signs of diffuse or localized [[thrombosis]] | ||
* Bleeding into [[serous]] cavities | * Bleeding into [[serous]] cavities | ||
Nervous: | |||
=== Nervous: === | |||
* Nonspecific altered [[consciousness]] or [[stupor]] | * Nonspecific altered [[consciousness]] or [[stupor]] | ||
* Transient focal [[Neurological|neurologic]] deficits | * Transient focal [[Neurological|neurologic]] deficits | ||
Cardiovascular: | |||
=== Cardiovascular: === | |||
* [[Hypotension]] | * [[Hypotension]] | ||
* [[Tachycardia]] | * [[Tachycardia]] | ||
* [[Circulatory]] collapse | * [[Circulatory]] collapse | ||
Respiratory: | |||
=== Respiratory: === | |||
* [[Pleural friction rub]] | * [[Pleural friction rub]] | ||
* Signs of [[acute respiratory distress syndrome]] (ARDS) | * Signs of [[acute respiratory distress syndrome]] (ARDS) | ||
Gastrointestinal: | |||
=== Gastrointestinal: === | |||
* [[Hematemesis]] | * [[Hematemesis]] | ||
* [[Hematochezia]] | * [[Hematochezia]] | ||
Genitourinary: | |||
=== Genitourinary: === | |||
* Signs of [[azotemia]] and [[renal failure]] | * Signs of [[azotemia]] and [[renal failure]] | ||
* [[Acidosis]] | * [[Acidosis]] | ||
| Line 34: | Line 39: | ||
* [[Metrorrhagia]] | * [[Metrorrhagia]] | ||
* [[Uterine hemorrhage]] | * [[Uterine hemorrhage]] | ||
Skin: | |||
=== Skin: === | |||
* [[Petechiae]] | * [[Petechiae]] | ||
* [[Jaundice]] (liver dysfunction or hemolysis) | * [[Jaundice]] (liver dysfunction or hemolysis) | ||
Latest revision as of 16:22, 19 September 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omer Kamal, M.D.[2]
Overview
Common physical examination findings of DIC include signs of spontaneous and life-threatening hemorrhage, signs of subacute bleeding, signs of diffuse or localized thrombosis, bleeding into serous cavities, nonspecific altered consciousness or stupor, transient focal neurologic deficits, hypotension, tachycardia, circulatory collapse, pleural friction rub, signs of acute respiratory distress syndrome (ARDS), hematemesis, hematochezia, signs of azotemia and renal failure, acidosis, hematuria, oliguria, metrorrhagia and uterine hemorrhage.
Physical Examination
Physical examination of patients with DIC is usually remarkable for the following:[1][2][3][4][5]
Hemtological:
- Signs of spontaneous and life-threatening hemorrhage
- Signs of subacute bleeding
- Signs of diffuse or localized thrombosis
- Bleeding into serous cavities
Nervous:
- Nonspecific altered consciousness or stupor
- Transient focal neurologic deficits
Cardiovascular:
- Hypotension
- Tachycardia
- Circulatory collapse
Respiratory:
- Pleural friction rub
- Signs of acute respiratory distress syndrome (ARDS)
Gastrointestinal:
Genitourinary:
- Signs of azotemia and renal failure
- Acidosis
- Hematuria
- Oliguria
- Metrorrhagia
- Uterine hemorrhage
Skin:
- Petechiae
- Jaundice (liver dysfunction or hemolysis)
- Purpura
- Hemorrhagic bullae
- Acral cyanosis
- Skin necrosis of lower limbs (purpura fulminans)
- Localized infarction and gangrene
- Wound bleeding and deep subcutaneous hematomas
- Thrombosis
References
- ↑ Miyashima Y, Iwamuro M, Shibata M, Miyabe Y, Kawai Y, Kaihara M, Mitogawa T, Harada M (January 2018). "Prediction of Disseminated Intravascular Coagulation by Liver Function Tests in Patients with Japanese Spotted Fever". Intern. Med. 57 (2): 197–202. doi:10.2169/internalmedicine.8420-16. PMC 5820036. PMID 29021432.
- ↑ Iba T, Arakawa M, Ohchi Y, Arai T, Sato K, Wada H, Levy JH (September 2018). "Prediction of Early Death in Patients With Sepsis-Associated Coagulation Disorder Treated With Antithrombin Supplementation". Clin. Appl. Thromb. Hemost.: 1076029618797474. doi:10.1177/1076029618797474. PMID 30198317.
- ↑ Kilicci C, Ozkaya E, Karakus R, Sanverdi I, Abide Yayla C, Bostanci Ergen E, Mutlu S (September 2018). "Early low molecular weight heparin for postpartum hemorrhage in women with pre-eclampsia. Is it effective to prevent consumptive coagulopathy?". J. Matern. Fetal. Neonatal. Med.: 1–5. doi:10.1080/14767058.2018.1494708. PMID 30189766.
- ↑ McBride AM (2018). "Clinical Presentation and Treatment of Amniotic Fluid Embolism". AACN Adv Crit Care. 29 (3): 336–342. doi:10.4037/aacnacc2018419. PMID 30185500.
- ↑ Judkins AJ, MacQueen BC, Christensen RD, Henry E, Snow GL, Bennett ST (September 2018). "Automated Quantification of Fragmented Red Blood Cells: Neonatal Reference Intervals and Clinical Disorders of Neonatal Intensive Care Unit Patients with High Values". Neonatology. 115 (1): 5–12. doi:10.1159/000491626. PMID 30184540.