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Diagnosis and treatment of disseminated intravascular coagulation

Sameer Bakhshi1, L S Arya

  • 1Department of Pediatrics, Division of Hematology Oncology, All India Institute of Medical Sciences, New Delhi 110 029, India. sambakh@hotmail.com

Indian Pediatrics
|September 3, 2003
PubMed

Insights

Disseminated intravascular coagulation (DIC) involves complex clotting and bleeding issues. D-dimer is the most sensitive diagnostic test, and treatment focuses on the underlying cause, not just symptoms.

Area of Science:

  • Hematology
  • Critical Care Medicine

Background:

  • Disseminated intravascular coagulation (DIC) is a life-threatening syndrome characterized by widespread activation of coagulation and fibrinolysis.
  • It involves consumption of clotting factors and inhibitors, leading to both bleeding and thrombosis.
  • Traditional diagnostic markers may be unreliable in chronic DIC cases.

Purpose of the Study:

  • To review controversies in the diagnosis and management of DIC.
  • To highlight the diagnostic utility of D-dimer.
  • To discuss therapeutic strategies, including the role of anticoagulants.

Main Methods:

  • Literature review of existing studies and clinical guidelines on DIC.
  • Analysis of diagnostic criteria and therapeutic interventions.
  • Discussion of controversial aspects in DIC management.

Main Results:

  • Bleeding is a common manifestation, but microvascular thrombosis causes significant morbidity and mortality.
  • D-dimer estimation is the most sensitive and specific diagnostic marker for DIC.
  • Standard tests like platelet count and prothrombin time can be normal in chronic DIC.

Conclusions:

  • Effective DIC management requires addressing the primary underlying condition.
  • Transfusion products (FFP, platelets) carry risks and are reserved for bleeding patients.
  • The roles of heparin and antithrombin in sepsis-associated DIC warrant careful consideration.

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