Disseminated intravascular coagulation

Abstract

Disseminated intravascular coagulation (DIC), a synonym of consumption coagulopathy, is an acquired clinical syndrome characterized by abnormally increased activation of procoagulant pathways. This condition results in intravascular fibrin deposition and decreased levels of hemostatic components, including platelets, fibrinogen, and other clotting factors. DIC is characterized by pathological dysregulation of the hemostatic and fibrinolytic processes as a consequence of systemic activation of coagulation and fibrinolysis. DIC complicates a wide range of medical and surgical illnesses secondary to various underlying conditions (e.g., shock, trauma, burns, obstetric complications, severe infections and sepsis, organ dysfunction, and malignancies). The diagnosis of DIC should encompass both clinical and laboratory data. The DIC scoring system promoted by the International Society on Thrombosis and Haemostasis provides objective measurement of the DIC process. During the condition of consumption coagulopathy, the scoring system correlates with clinical observations and outcome. It is important to monitor the dynamically changing scenario based on laboratory tests and clinical assessment in patients suffering from several syndromes leading to hemorrhage and/or thrombosis conditions. However, the cornerstone of the treatment of DIC remains the treatment of the underlying diseases. Consumption coagulopathy represents an important challenge for critical care physicians and intensivists.