Diagnostic Scores and Treatment Options for Acute Disseminated Intravascular Coagulation in Children

Abstract

Disseminated intravascular coagulation (DIC) is a thrombo-hemorrhagic condition that commonly accompanies life-threatening illnesses in children and is associated with significant morbidity and mortality. Treatment of underlying conditions, hemodynamic support, and replacement therapy with blood components is the mainstay of DIC management. Limited research studies have supported the use of antithrombin (AT), recombinant thrombomodulin (rTM), and protein C concentrates (PrCC). Although there have been several studies and advancements in the DIC treatment in adults, data in pediatric patients are limited, and the consensus is lacking. Evidence validating the use of diagnostic scoring systems in the pediatric population is also limited. Since the hemostatic system differs significantly in children, especially in neonates, management of DIC is also different in children from that of adults, and there is a dire need for good quality research studies in this aspect.We reviewed more than 100 articles in PubMed, Cochrane database, and Google Scholar. This traditional review article discusses different scoring systems for diagnosing DIC in pediatric patients, and different pharmacological treatment options for acute DIC in this population. This study mainly focuses on papers published from 1990 to 2021 and includes papers in all languages involving humans only.

Outcomes of Overt and Non-Overt Disseminated Intravascular Coagulation Using the Isth Dic Scoring System in Children: A Single-Center Study

“…Concordant with other studies, 16,17 the 28-day case fatality rate of children with overt DIC or those with organ dysfunction requiring advanced organ support was significantly higher than that for children with non-overt DIC. Additionally, mortality was significantly correlated with the ISTH DIC score and the clinical parameters platelet number, prothrombin time, and D-dimer.…”