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30 year old female with newly diagnosed Diffuse Large B cell Lymphoma treated with chemotherapy

Developed a GI bleed
Developed skin changes on her flank thought to be necrotizing fasciitis
Underwent extensive debridement

Pertinent Lab Studies

PT/INR 16 secs./1.6
Fibrinogen 50 mg/dL
Fibrin degradation products >80
Platelet count 65,000/uL
Hemoglobin in the 6-8 g/dL
Room air ABG: pH 7.22 PCO2 29 PO2 78 HCO3-   11.

 

 

What is happening with the patient’s coagulation? Be specific.
What is the treatment? Be specific with all of the treatments for this patient.
Evaluate the patient’s ABG and discuss treatment.
What is the most likely progression of this disease?
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