Disseminated intravascular coagulation. Approach to treatment

Area of Science:

• Hematology
• Pathophysiology
• Critical Care Medicine

Background:

• Disseminated intravascular coagulation (DIC) is a life-threatening syndrome characterized by systemic thrombin generation.
• DIC results from pathological activation of coagulation pathways, often triggered by sepsis, malignancy, or trauma.
• Diagnosis relies on specific laboratory abnormalities, including prothrombin time, platelet count, fibrinogen, and fibrin degradation products.

Purpose of the Study:

• To outline the pathophysiology, diagnosis, and management strategies for disseminated intravascular coagulation (DIC).
• To differentiate clinical manifestations and treatment approaches for acute versus chronic DIC.
• To provide guidance on therapeutic interventions, including anticoagulation and supportive care.

Main Methods:

• Review of existing literature on DIC pathophysiology and clinical presentation.
• Analysis of diagnostic criteria based on laboratory values.
• Evaluation of treatment protocols for acute and chronic DIC, including heparin therapy and supportive measures.

Main Results:

• The most common presentation of DIC is bleeding, though thrombosis occurs in chronic forms, particularly with malignancy.
• Acute DIC management prioritizes treating the underlying condition and supportive care; heparin is indicated for severe hemorrhage or thrombosis.
• Chronic DIC, especially with thrombosis, is managed with heparin; warfarin is ineffective, and long-term heparin may be necessary.

Conclusions:

• Effective management of DIC requires prompt diagnosis and tailored treatment based on the underlying cause and clinical presentation.
• Heparin anticoagulation is a key therapeutic option for severe or persistent DIC, particularly in chronic cases.
• Addressing the primary disease and providing supportive care are crucial for improving outcomes in patients with DIC.