thrombin and/or plasmin produce at a rate that exceeds their natural inhibitors to neutralize

circulate in vascular system and activate coagulation and fibrinolytic proceses

clotting and bleeding occur

acquired disease

consumption of coagulation factors and platelets

generation of thrombin

widespread deposits of fibrin in small vessels

infections

production of endotoxoins and/or generation of cytokines

renal failure

coma

liver failure

respiratory failure

skin necrosis, gangrene

venous thromboembolism

mortality in 50 - 60% cases

decreased platelet count 40-75 x 10⁹/L due to thrombin activation and clearance

prolonged PT and APTT due to reduction of clotting factors

decreased factors II, V, VIII, X

decrease in fibrinogen due to conversion of fibrin monomer and fibrin

increase in FDP due to secondary lysis of fibrinogen and fibrin

90% certain when PT, fibrinogen, and platelet count are abnormal

or

two of the three tests are abnormal with an elevated fibrin degradation products (FDP)

eliminate the primary condition

DIC with bleeding requires replacement therapy

DIC with thromboemboli requires heparin