Pathophysiology, diagnosis and treatment of disseminated intravascular coagulation

Abstract

Disseminated intravascular coagulation (DIC) is a syndrome characterized by systemic intravascular activation of coagulation, leading to widespread deposition of fibrin in the circulation. The fibrin deposition contributes to multiple organ failure. The massive and ongoing activation of coagulation may result in depletion of platelets, fibrinogen and other coagulation factors, which may cause bleeding (consumption coagulopathy). Disseminated intravascular coagulation is not a disease in itself but is a complication of a variety of disorders and clinical conditions. There is no single lab test sufficiently accurate to establish or reject a diagnosis of DIC. However, a combination of widely available haemostatic lab tests, may be helpful in making the diagnosis of DIC, according to a recently developed algorithm. The cornerstone of the treatment of DIC is the specific and vigorous treatment of the underlying disorder. Other therapeutic strategies comprise blood components replacement therapy, inhibition of coagulation activation (heparin, activated protein C) and — very rarely — antifibrinolytics.
Hematologia 2011; 2, 4: 326–331