Abstract
Disseminated intravascular coagulation (DIC) is an acquired disorder in which normal hemostatic balance is disturbed. There is excessive thrombin formation leading to fibrin deposition in microcirculation and consequent ischemic organ damage. The etiology is multifactorial. A number of medical, surgical, oncological and obstetrical conditions can cause DIC. The diagnosis is essentially clinical supported by laboratory parameters and a scoring system based on these. The mainstay of treatment is correction of underlying cause and hemostatic support with replacement of coagulation factors. The role of heparin therapy and other therapeutic options including activated protein C, antithrombin III etc. have also been discussed.
Similar content being viewed by others
References
Franchini M. Pathophysiology, diagnosis and treatment of disseminated intravascular coagulation: un update. Clin Lab 2005; 5: 633–639.
Hambleton J, Leung LL, Levi M. Coagulation: consultative hemostasis. Hematology 2002; 2002: 335–352.
Zeerleder S, Hack E, Wuillemin WA. Disseminated intravascular coagulation in sepsis. Chest 2005; 128: 2861–2875
Horan JT, Francis CW. Fibrin degradation products, fibrin monomer and soluble fibrin in disseminated intravascular coagulation. Semin Thromb Hemost 2001; 27: 657–666.
Taylor FB Jr, Toh CH, Hoots WK, Wada H, Levi M. Towards definition, clinical and laboratory criteria and a scoring system for disseminated intravascular coagulation. Thromb Haemost 2001; 86: 1327–1330.
Baglin T. Disseminated intravascular coagulation: diagnosis and treatment. BMJ 1996; 312: 683–687.
Levi M, TenCate H. Disseminated intravascular coagulation. N Engl J Med 1999; 341: 586–592
Dhainaut JF, Yan SB, Cariou A, Mira JP. Soluble thrombomodulin, plasma derived unactivated protein C and recombinanat human activated protein C in sepsis. Crit Care Med 2002; 30: 318–324.
Bernard GR, Vincent JL, Laterre PF, LaRosa SP, Dhainaut JF, Lopez-Rodriguez A et al. Efficacy and safety of recombinant human activated protein C for severe sepsis. N Eng J Med 2001; 344: 699–709.
Goldstein B, Nadel S, Peter M, Barton R, Machado F, Levy H et al. ENHANCE: results of a global open-level trial of drotrecogin alfa (activated) in children with severe sepsis. Pediatr Crit Care Med 2006; 7: 277–278.
Camporota L, Wyncoll D. Practical aspects of treatment with drotrecogin alfa (activated). Crit Care 2007; 11 suppl 5: S7.
Dellinger RP. Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock. Crit Care Med 2008; 36: 1394–1396.
Warren BL, Eid A, Singer P, Pillay SS, Carl P, Novak I et al. Caring for the critically ill patient. High dose anti-thrombin III in severe sepsis: a randomized controlled trial. JAMA 2001; 286: 1869–1878.
Kienast J, Juers M, Wiedermann CJ, Hoffmann JN, Ostermann H, Strauss R et al. Treatment effects of high-dose anti thrombin without concomitant heparin in patients with severe sepsis with or without disseminated intravascular coagulation. J Thromb Haemost 2006; 4: 90–97.
Abraham E, Reinhart K, Opal S, Deineyer I, Daig C, Rodriguez AL et al. OPTIMIST Trial study group. Efficacy and safety of tifacogin (recombinant tissue factor pathway inhibitor) in severe sepsis: a randomized controlled trial. JAMA 2003; 290: 237–238.
Nishiyama T, Matsukawa T, Hanaoka K. Is protease inhibitor a choice for the treatment of pre or mild disseminated intravascular coagulation? Crit Care Med 2000; 27: 657–666.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kumar, R., Gupta, V. Disseminated Intravascular Coagulation: Current Concepts. Indian J Pediatr 75, 733–738 (2008). https://doi.org/10.1007/s12098-008-0139-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12098-008-0139-x