Fortnightly Review: Disseminated intravascular coagulation: diagnosis and treatment

BMJ 1996;312:683-686 (16 March)

Education and debate

Trevor Baglin, consultant haematologist ^a

^a Department of Haematology, Addenbrooke's NHS Trust, Cambridge CB2 2QQ

Summary points

Disseminated intravascular coagulation is primarily a clinical diagnosis, and laboratory tests are used to confirm the diagnosis and monitor replacement of blood components
Tests required are platelet count, prothrombin time, activated partial thromboplastin time, fibrinogen, and a measure of fibrinogen degradation products
Treatment of disseminated intravascular coagulation is primarily that of the underlying condition
Maintenance of blood volume and tissue perfusion is essential in all cases of disseminated intravascular coagulation
Replacement of blood components is indicated if the patient is bleeding or an invasive procedure is required and must be monitored

Levi, M., Keller, T. T, van Gorp, E., ten Cate, H. (2003). Infection and inflammation and the coagulation system. Cardiovasc Res 60: 26-39 [Abstract] [Full text]
Gragasin-Saviano, L., Isaacson, E., Stuck, R. M. (2002). Pedal Gangrene Secondary to Disseminated Intravascular Coagulation with Gastric Carcinoma. J. Am. Podiatr. Med. Assoc. 92: 149-152 [Abstract] [Full text]
Hambleton, J., Leung, L. L., Levi, M. (2002). Coagulation: Consultative Hemostasis. ASH Education Book 2002: 335-352 [Abstract] [Full text]
Levi, M., ten Cate, H. (1999). Disseminated Intravascular Coagulation. NEJM 341: 586-592 [Full text]
Stephan, F., Hollande, J., Richard, O., Cheffi, A., Maier-Redelsperger, M., Flahault, A. (1999). Thrombocytopenia in a Surgical ICU. Chest 115: 1363-1370 [Abstract] [Full text]
Asherson, R. (1998). Review : The catastrophic antiphospholipid syndrome, 1998: A review of the clinical features, possible pathogenesis and treatment. Lupus 7: S55-S62 [Abstract]