Naturally occurring inhibitors, including prostacycline and antithrombin III, normally control the intravascular clotting process. The amount and rate of entry of thromboplastins into the circulation determine the severity and rapidity of the process. A corollary of primary importance in therapy is removal of the source of thromboplastic agents if possible. The process of intravascular coagulation results in the partial to nearly complete conversion of plasma to serum. Clotting factors are variously converted with factors V and VIII completely destroyed, with small amounts of VII, IX, and X activated and lost due to the action of antithrombin.
Platelets undergo changes in configuration and release reactions.
Later and concurrently, fibrinogen is cleared and fibrin lysed to give rise to fibrin monomer aggregates and fibrin degradation products. 1 Varying levels of complexity in interpretation are introduced by the multitest nature of the DIC screen and the need for clinical correlation. If all test results are normal, it is very unlikely that any significant degree of intravascular coagulation and lysis is in progress. This is also a finding against physiologic clot formation and lysis of any significant degree. Process of DIC is frequently dynamic with changes occurring rapidly.