Disseminated Intravascular Coagulation Follow-up

  • Author: Marcel M Levi, MD; Chief Editor: Emmanuel C Besa, MD   more...
 
Updated: Oct 26, 2011
 

Further Inpatient Care

  • If unclear, a diagnostic workup in search of the underlying condition causing disseminated intravascular coagulation (DIC) should be initiated.
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Complications

  • Death is the most serious complication in cases of disseminated intravascular coagulation (DIC).
  • Organ dysfunction and limb ischemia may occur.
  • Bleeding, which can be excessive, may seriously complicate the clinical course of a patient with disseminated intravascular coagulation (DIC).
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Prognosis

  • The prognosis of disseminated intravascular coagulation (DIC) depends on the underlying disorder. If the underlying condition is self-limited or can be appropriately handled, the disseminated intravascular coagulation (DIC) will disappear, and the coagulation status will normalize.
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Contributor Information and Disclosures
Author

Marcel M Levi, MD  Dean, Academic Medical Center, University of Amsterdam, the Netherlands

Marcel M Levi, MD is a member of the following medical societies: American Society of Hematology and International Society on Thrombosis and Haemostasis

Disclosure: Nothing to disclose.

Coauthor(s)

Alvin H Schmaier, MD  Robert W Kellermeyer Professor of Hematology/Oncology, Case Western Reserve University School of Medicine; Chief, Division of Hematology/Oncology, Case Western Reserve University

Alvin H Schmaier, MD is a member of the following medical societies: American Federation for Medical Research, American Heart Association, American Society for Clinical Investigation, American Society of Hematology, Association of American Physicians, Central Society for Clinical Research, and International Society on Thrombosis and Haemostasis

Disclosure: Nothing to disclose.

Specialty Editor Board

Pradyumna D Phatak, MBBS, MD  Chair, Division of Hematology and Medical Oncology, Rochester General Hospital; Clinical Professor of Oncology, Roswell Park Cancer Institute

Pradyumna D Phatak, MBBS, MD, is a member of the following medical societies: American Society of Hematology

Disclosure: Novartis Honoraria Speaking and teaching

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Ronald A Sacher, MB, BCh, MD, FRCPC  Professor, Internal Medicine and Pathology, Director, Hoxworth Blood Center, University of Cincinnati Academic Health Center

Ronald A Sacher, MB, BCh, MD, FRCPC is a member of the following medical societies: American Association for the Advancement of Science, American Association of Blood Banks, American Clinical and Climatological Association, American Society for Clinical Pathology, American Society of Hematology, College of American Pathologists, International Society of Blood Transfusion, International Society on Thrombosis and Haemostasis, and Royal College of Physicians and Surgeons of Canada

Disclosure: Glaxo Smith Kline Honoraria Speaking and teaching; Talecris Honoraria Board membership

Rajalaxmi McKenna, MD, FACP  Southwest Medical Consultants, SC, Department of Medicine, Good Samaritan Hospital, Advocate Health Systems

Rajalaxmi McKenna, MD, FACP is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology, and International Society on Thrombosis and Haemostasis

Disclosure: Nothing to disclose.

Chief Editor

Emmanuel C Besa, MD  Professor, Department of Medicine, Division of Hematologic Malignancies, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University

Emmanuel C Besa, MD is a member of the following medical societies: American Association for Cancer Education, American College of Clinical Pharmacology, American Federation for Medical Research, American Society of Clinical Oncology, American Society of Hematology, and New York Academy of Sciences

Disclosure: Nothing to disclose.

References

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  4. Leblebisatan G, Sasmaz I, Antmen B, et al. Management of life-threatening hemorrhages and unsafe interventions in nonhemophiliac children by recombinant factor VIIa. Clin Appl Thromb Hemost. Oct 6 2008;epub ahead of print. [Medline].

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  6. Sawamura A, Hayakawa M, Gando S, Kubota N, Sugano M, Wada T, et al. Disseminated intravascular coagulation with a fibrinolytic phenotype at an early phase of trauma predicts mortality. Thromb Res. Aug 4 2009;[Medline].

  7. Sivula M, Pettilä V, Niemi TT, Varpula M, Kuitunen AH. Thromboelastometry in patients with severe sepsis and disseminated intravascular coagulation. Blood Coagul Fibrinolysis. Sep 2009;20(6):419-26. [Medline].

  8. Sawamura A, Hayakawa M, Gando S, Kubota N, Sugano M, Wada T, et al. Application of the Japanese Association for Acute Medicine disseminated intravascular coagulation diagnostic criteria for patients at an early phase of trauma. Thromb Res. Aug 1 2009;[Medline].

  9. Zhu YJ, Huang XK. Relationship between disseminated intravascular coagulation and levels of plasma thrombinogen segment 1+2, D-dimer, and thrombomodulin in patients with multiple injuries. Chin J Traumatol. Aug 2009;12(4):203-9. [Medline].

  10. Duchesne JC, Islam TM, Stuke L, Timmer JR, Barbeau JM, Marr AB, et al. Hemostatic resuscitation during surgery improves survival in patients with traumatic-induced coagulopathy. J Trauma. Jul 2009;67(1):33-7; discussion 37-9. [Medline].

  11. Takashima A, Shirao K, Hirashima Y, Takahari D, Okita NT, Nakajima TE, et al. Sequential chemotherapy with methotrexate and 5-fluorouracil for chemotherapy-naive advanced gastric cancer with disseminated intravascular coagulation at initial diagnosis. J Cancer Res Clin Oncol. Sep 2 2009;[Medline].

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  14. Taylor FB Jr, Toh CH, Hoots WK, et al, for the Scientific Subcommittee on Disseminated Intravascular Coagulation (DIC) of the ISTH. Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost. Nov 2001;86(5):1327-30. [Medline]. [Full Text].

  15. Levi M, Levy M, Williams MD, Douglas I, Artigas A, Antonelli M, et al. Prophylactic heparin in patients with severe sepsis treated with drotrecogin alfa (activated). Am J Respir Crit Care Med. Sep 1 2007;176(5):483-90. [Medline].

  16. Sawamura A, Gando S, Hayakawa M, et al. Effects of antithrombin III in patients with disseminated intravascular coagulation diagnosed by newly developed diagnostic criteria for critical illness. Clin Appl Thromb Hemost. Oct 7 2008;epub ahead of print. [Medline].

  17. Yamakawa K, Fujimi S, Mohri T, Matsuda H, Nakamori Y, Hirose T, et al. Treatment effects of recombinant human soluble thrombomodulin in patients with severe sepsis: a historical control study. Crit Care. 2011;15(3):R123. [Medline].

  18. Dhainaut JF, Yan SB, Joyce DE, et al. Treatment effects of drotrecogin alfa (activated) in patients with severe sepsis with or without overt disseminated intravascular coagulation. J Thromb Haemost. Nov 2004;2(11):1924-33. [Medline].

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  21. Schmaier AH. Disseminated intravascular coagulation - pathogenesis and management. J Intens Care Med. 1991;6:209-28.

 
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Diagnostic algorithm for the diagnosis of overt disseminated intravascular coagulation.
 
 
 
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