Disseminated Intravascular Coagulation

Abstract

The massive tissue factor stimulus results in excess intravascular thrombin, which overcomes the anticoagulant systems and leads to thrombosis. Because of consumption of coagulation factors and platelets, DIC also has a hemorrhagic phase. Treatment of the bleeding patient with DIC is supportive with the use of blood components.

How I treat disseminated intravascular coagulation

“…DIC is classically characterized by the simultaneous occurrence of widespread vascular clot deposition, compromising an adequate blood supply to various organs, and thereby contributing to organ failure. [2][3][4][5] Due to ongoing activation of the coagulation system and other factors, such as impaired synthesis and increased degradation of coagulation proteins and protease inhibitors, exhaustion of factors and platelets may occur, potentially resulting in profuse bleeding from various sites. In addition, high levels of fibrin degradation products may affect platelet function and fibrin cross-linking and thereby further contribute to the bleeding tendency.…”

Evaluating the analytical performance of five new coagulation assays for the measurement of prothrombin time and activated thromboplastin time

“…Coagulopathies occur in patients across all healthcare settings, often resulting in clinically significant bleeding or thrombosis, depending on the nature of the defect. [1][2][3][4][5][6] A number of possible aetiologies exist, including trauma, disease (eg, liver disease, sepsis, cancer), surgery, pharmacological treatment (eg, unfractionated heparin [UFH], vitamin K antagonists, direct factor Xa-and direct thrombin inhibitors) and genetic or acquired deficiencies in coagulation factors. 3,[7][8][9][10][11] The ability to accurately, reliably and quickly measure indicators of haemostatic function, and to subsequently implement corrective measures, is thus important for patient health.…”

Evaluating the analytical performance of four new coagulation assays for the measurement of fibrinogen, D‐dimer and thrombin time

“…D‐dimer is a very sensitive marker for the activation of coagulation . In DIC, fibrin degradation products, such as D‐dimer, can be used to confirm or refute a tentative diagnosis, estimate the potential risk for patients with existing DIC, and monitor an initiated therapy . D‐dimer levels are particularly useful to exclude deep vein thrombosis (DVT) and pulmonary embolism (PE), and may be elevated in the presence of other causes of fibrin formation such as trauma, pregnancy complications, malignant disease or vascular abnormalities …”

“…[18][19][20][21][22][23][24] In DIC, fibrin degradation products, such as D-dimer, can be used to confirm or refute a tentative diagnosis, estimate the potential risk for patients with existing DIC, and monitor an initiated therapy. [25][26][27] D-dimer levels are particularly useful to exclude deep vein thrombosis (DVT) and pulmonary embolism (PE), and may be elevated in the presence of other causes of fibrin formation such as trauma, pregnancy complications, malignant disease or vascular abnormalities. [25][26][27][28][29][30] High-throughput technologies designed for use in core laboratories and developed to measure fibrinogen, prothrombin time (PT)derived fibrinogen, thrombin time and D-dimer may offer significant benefits, such as reduced error rates and increased efficiency.…”

“…[25][26][27] D-dimer levels are particularly useful to exclude deep vein thrombosis (DVT) and pulmonary embolism (PE), and may be elevated in the presence of other causes of fibrin formation such as trauma, pregnancy complications, malignant disease or vascular abnormalities. [25][26][27][28][29][30] High-throughput technologies designed for use in core laboratories and developed to measure fibrinogen, prothrombin time (PT)derived fibrinogen, thrombin time and D-dimer may offer significant benefits, such as reduced error rates and increased efficiency. This multicentre study aimed to evaluate the performance of four new coagulation assays on the cobas t 711 and cobas t 511 analysers, which have been developed to measure fibrinogen, among others, PT-derived fibrinogen, thrombin time and D-dimer levels.…”