An intensive care patient develops sepsis. His blood pressure drops to 60/15 mm Hg and he stas to bleed from venipuncture sites. Disseminated intravascular coagulation is suspected. Which of the following sets of stat laboratory values would confirm the likely diagnosis?
Disseminated intravascular coagulation (DIC) is a feared complication of many serious illnesses, including obstetric complications, sepsis, malignancies, and severe trauma. The most characteristic initiating event is formation (and often subsequent lysis) of microthrombi composed of platelets, fibrin, and coagulative factors. The consumption of coagulative factors leads to increased prothrombin time (PT) and paial thromboplastin time (PTT). The consumption of platelets leads to a decreased platelet count. A more specific confirmatory test is an increase in fibrin split products, such as "D-dimers." Characteristically, DIC clinically produces a mix of hemorrhagic and coagulative complications, and is difficult to treat because correcting the coagulative tendency tends to worsen the hemorrhage, and correcting the hemorrhagic tendency tends to worsen thrombotic complications. Ref: Arruda V.R. (2012). Chapter 116. Coagulation Disorders. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
Decreased PT, decreased PTT, decreased platelets
Decreased PT, elevated PTT, decreased platelets
Decreased PT, elevated PTT, elevated platelets
Elevated PT, elevated PTT, decreased platelets