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Disseminated intravascular coagulation and related syndromes: a clinical review
1Department of Medicine, University of California, Los Angeles.
Insights
Disseminated intravascular coagulation (DIC) involves complex pathophysiology and diagnosis. Understanding these mechanisms is crucial for managing DIC and related organ-specific disorders, though treatments remain controversial.
Area of Science:
- Hematology
- Pathophysiology
- Critical Care Medicine
Background:
- Disseminated intravascular coagulation (DIC) presents a complex clinical and laboratory picture.
- Interrelationships between DIC and other organ-specific syndromes are often confusing.
- Current understanding of DIC's etiology, mechanisms, diagnosis, and management is evolving.
Purpose of the Study:
- To discuss current concepts regarding disseminated intravascular coagulation (DIC).
- To clarify the pathophysiologic interrelationships in DIC.
- To highlight the challenges in diagnosing and managing DIC and related disorders.
Main Methods:
- Review of current literature on DIC.
- Discussion of pathophysiologic mechanisms.
- Analysis of clinical and laboratory findings in DIC patients.
Main Results:
- DIC exhibits a wide spectrum of clinical and laboratory findings.
- Many organ-specific syndromes share pathophysiologic properties with DIC.
- Therapeutic decisions for DIC remain controversial due to limited evidence.
Conclusions:
- A clear understanding of DIC's pathophysiology is essential for effective clinical management.
- Distinguishing DIC from similar organ-specific disorders like HUS and eclampsia is critical.
- Further research on therapeutic modalities and survival patterns in DIC is needed.
Abstract:
Current concepts of the cause, pathophysiologic mechanisms, diagnosis, and management of acute and chronic DIC have been discussed. Considerable attention has been devoted to interrelationships that have remained confusing. Only by clearly understanding these pathophysiologic interrelationships can the clinician and laboratorian appreciate the divergent and wide clinical spectrum of often confusing clinical and laboratory findings in patients with DIC. Many of the therapeutic decisions to be made in these patients remain controversial and will remain so until more series of patients are published with respect to specific therapeutic modalities and survival patterns. Many syndromes that remain organ specific share common pathophysiologic properties with DIC but are identified as an independent disease entity, such as HUS, adult shock lung syndrome, eclampsia, and many other isolated organ-specific disorders. Many of these similar disorders, some systemic and some organ specific or multiorgan specific, are listed in Table 36.