Skip to main content

Advertisement

Log in

Disseminated Intravascular Coagulation: Current Concepts

  • Symposium on Advances in Hematology
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Franchini M. Pathophysiology, diagnosis and treatment of disseminated intravascular coagulation: un update. Clin Lab 2005; 5: 633–639.

    Google Scholar 

  2. Hambleton J, Leung LL, Levi M. Coagulation: consultative hemostasis. Hematology 2002; 2002: 335–352.

    Article  Google Scholar 

  3. Zeerleder S, Hack E, Wuillemin WA. Disseminated intravascular coagulation in sepsis. Chest 2005; 128: 2861–2875

    Article  Google Scholar 

  4. Horan JT, Francis CW. Fibrin degradation products, fibrin monomer and soluble fibrin in disseminated intravascular coagulation. Semin Thromb Hemost 2001; 27: 657–666.

    Article  PubMed  CAS  Google Scholar 

  5. 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.

    PubMed  CAS  Google Scholar 

  6. Baglin T. Disseminated intravascular coagulation: diagnosis and treatment. BMJ 1996; 312: 683–687.

    PubMed  CAS  Google Scholar 

  7. Levi M, TenCate H. Disseminated intravascular coagulation. N Engl J Med 1999; 341: 586–592

    Article  PubMed  CAS  Google Scholar 

  8. 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.

    Article  Google Scholar 

  9. 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.

    Article  CAS  Google Scholar 

  10. 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.

    Article  Google Scholar 

  11. Camporota L, Wyncoll D. Practical aspects of treatment with drotrecogin alfa (activated). Crit Care 2007; 11 suppl 5: S7.

    Article  PubMed  Google Scholar 

  12. Dellinger RP. Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock. Crit Care Med 2008; 36: 1394–1396.

    Article  Google Scholar 

  13. 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.

    Article  PubMed  CAS  Google Scholar 

  14. 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.

    Article  PubMed  CAS  Google Scholar 

  15. 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.

    Article  Google Scholar 

  16. 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.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to R. Kumar.

Rights and permissions

Reprints 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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-008-0139-x

Key words

Navigation