Abstract
Current concepts of the etiology, pathophysiology, clinical and laboratory diagnosis
and management of fulminant and low-grade disseminated intravascular coagulation (DIC)
have been presented. Considerable attention has been devoted to interrelationships
within the hemostasis system. Only by clearly understanding these pathophysiological
interrelationships can the clinician and laboratory scientist appreciate the divergent
and wide spectrum of often confusing clinical and laboratory findings in patients
with DIC. Objective clinical and laboratory criteria for diagnosis of DIC have been
delineated, thus avoiding needless confusion and empirical decisions regarding the
diagnosis. Many therapeutic decisions to be made are controversial and will remain
so until more is published about specific therapeutic modalities and survival patterns.
Also, therapy must be highly individualized depending on the nature of DIC, age, etiology
of DIC, site and severity of hemorrhage or thrombosis, and hemodynamic and other clinical
parameters. Also presented are clear criteria for severity of DIC and objective criteria
for defining a response to therapy. Also, since it is often difficult for the individual
physician to decide when to stop expensive therapy, objective criteria by which therapy
may be stopped when continuation is likely fruitless are presented as a guideline.
Keywords:
Disseminated intravascular coagulation - defibrination syndrome - hemorrhage - thrombosis
- sepsis
