[Disseminated intravascular coagulation associated with sepsis]

Sepsis is defined as life-threatening organ dysfunction caused by dysregulated host responses to infection. The prothrombotic/antithrombotic balance within blood vessels can be shifted toward prothrombotic in infectious diseases. This is a physiological defense mechanism intended to contain the disturbance in peripheral tissues and prevent it from reaching the central systems. However, in severe infections where this response does not remain localized, extensive ischemic organ damage leads to sepsis-associated disseminated intravascular coagulation (DIC) with multiple organ failure. In such cases, anticoagulation therapy can alleviate ischemic organ damage. The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024 and the Clinical Practice Guidelines for Management of DIC in Japan 2024 recommend antithrombin or recombinant thrombomodulin for sepsis-associated DIC. Further discussion is needed to determine the optimal candidates and methods for treatment.