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Expert consensus for the treatment of disseminated intravascular coagulation in Japan

Hideo Wada1, Hidesaku Asakura, Kohji Okamoto

  • 1Department of Molecular and Laboratory Medicine, Mie University School of Medicine, 2-174, Edobashi, Tsu, Mie-ken 514-8507, Japan. wadahide@clin.medic.mie-u.ac.jp

Thrombosis Research
|September 29, 2009
PubMed

Insights

This expert consensus outlines Japanese treatment guidelines for disseminated intravascular coagulation (DIC). Treatment strategies for DIC vary by type, including asymptomatic, bleeding, and organ failure, with specific drug recommendations for each.

Area of Science:

  • Hematology
  • Internal Medicine
  • Critical Care Medicine

Background:

  • Disseminated intravascular coagulation (DIC) is a complex syndrome with varying clinical presentations.
  • Effective management of DIC requires tailored therapeutic approaches based on disease type.

Purpose of the Study:

  • To provide an expert consensus on the treatment of disseminated intravascular coagulation (DIC) in Japan.
  • To classify DIC into distinct types and recommend specific treatments for each.

Main Methods:

  • The report synthesizes findings from clinical trials and expert opinions.
  • Treatment recommendations are categorized based on DIC classification: asymptomatic, marked bleeding, and organ failure types.

Main Results:

  • For asymptomatic DIC, low molecular weight heparin (LMWH), synthetic protease inhibitor (SPI), and antithrombin (AT) are suggested.
  • In marked bleeding DIC, LMWH, SPI, and AT are recommended, while SPI is preferred for severe bleeding.
  • For organ failure type DIC, AT is recommended, and blood transfusions are crucial for life-threatening bleeding.

Conclusions:

  • Treatment for DIC must be individualized according to its type.
  • While some treatments show promise, high-quality evidence for effectiveness is often limited.
  • Anticoagulant therapy, including LMWH, unfractionated heparin (UFH), and danaparoid sodium (DS), may be necessary for DIC associated with thrombosis.

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