4.6 Review

Disseminated intravascular coagulation: epidemiology, biomarkers, and management

Journal

BRITISH JOURNAL OF HAEMATOLOGY
Volume 192, Issue 5, Pages 803-818

Publisher

WILEY
DOI: 10.1111/bjh.17172

Keywords

disseminated intravascular coagulation; thrombosis; haemorrhage; sepsis; neoplasms

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Disseminated intravascular coagulation (DIC) is a systemic activation of the coagulation system, leading to microvascular thrombosis and hemorrhage. Underlying conditions like infection, cancer, or obstetrical complications initiate and propagate the DIC process. Timely and accurate diagnosis and treatment of DIC and its underlying causes are essential for prognosis.
Disseminated intravascular coagulation (DIC) is a systemic activation of the coagulation system, which results in microvascular thrombosis and, simultaneously, potentially life-threatening haemorrhage attributed to consumption of platelets and coagulation factors. Underlying conditions, e.g. infection, cancer, or obstetrical complications are responsible for the initiation and propagation of the DIC process. This review provides insights into the epidemiology of DIC and the current understanding of its pathophysiology. It details the use of diagnostic biomarkers, current diagnostic recommendations from international medical societies, and it provides an overview of emerging diagnostic and prognostic biomarkers. Last, it provides guidance on management. It is concluded that timely and accurate diagnosis of DIC and its underlying condition is essential for the prognosis. Treatment should primarily focus on the underlying cause of DIC and supportive treatment should be individualised according to the underlying aetiology, patient's symptoms and laboratory records.

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