Disseminated Intravascular Coagulation Questions & Answers

Updated: Oct 07, 2018
  • Author: Marcel M Levi, MD; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Questions & Answers

Overview

How is disseminated intravascular coagulation (DIC) characterized?

What is the ISTH definition of disseminated intravascular coagulation (DIC)?

What is the prevalence of disseminated intravascular coagulation (DIC) and which conditions may be complicated by DIC?

What causes disseminated intravascular coagulation (DIC)?

What are the symptoms of disseminated intravascular coagulation (DIC)?

How do acute and chronic disseminated intravascular coagulation (DIC) develop?

What is the pathogenesis of hematologic derangements in disseminated intravascular coagulation (DIC)?

When is thrombin generation detectable in the pathophysiology of disseminated intravascular coagulation (DIC)?

What is the role of tissue factor (TF) in the pathogenesis of disseminated intravascular coagulation (DIC)?

What is the role of thrombin in the pathophysiology of disseminated intravascular coagulation (DIC)?

What is the role of factor VIIa in the pathogenesis of disseminated intravascular coagulation (DIC)?

What prevents the pathogenesis of disseminated intravascular coagulation (DIC)?

What is the source of tissue factor (TF) in the pathogenesis of disseminated intravascular coagulation (DIC)?

How is thrombin generation regulation disrupted in the pathophysiology of disseminated intravascular coagulation (DIC)?

What reduces plasma levels of antithrombin in disseminated intravascular coagulation (DIC)?

What is the role of antithrombin in the pathophysiology of disseminated intravascular coagulation (DIC)?

What is the role of the protein C system in the pathophysiology of disseminated intravascular coagulation (DIC)?

What is the role of TF pathway inhibitor (TFPI) in the pathophysiology of disseminated intravascular coagulation (DIC)?

What is the role of the fibrinolytic system in the pathophysiology of disseminated intravascular coagulation (DIC)?

What suppresses fibrinolytic activity in the pathogenesis of disseminated intravascular coagulation (DIC)?

What effect do anti-TF antibodies or recombinant hirudin have on the inhibition of fibrinolysis in disseminated intravascular coagulation (DIC)?

What finding supports fibrinolysis as a preventive factor of multiorgan failure in disseminated intravascular coagulation (DIC)?

What is the role of von Willebrand factor (vWF) in the pathogenesis of disseminated intravascular coagulation (DIC)?

How are rare cases of disseminated intravascular coagulation (DIC) characterized?

What treatment is contraindicated in patients with disseminated intravascular coagulation (DIC)?

How do inflammatory and coagulation pathways interact in the pathophysiology of disseminated intravascular coagulation (DIC)?

What is the role of activated coagulation factors in the inflammatory process of disseminated intravascular coagulation (DIC)?

What are the disease pathways that lead to the development of disseminated intravascular coagulation (DIC)?

Which pathogens are associated with disseminated intravascular coagulation (DIC)?

Which factors increase the risk of developing disseminated intravascular coagulation (DIC) in patients with infections?

What is the role of trauma in the development of disseminated intravascular coagulation (DIC)?

Which conditions may be complicated by disseminated intravascular coagulation (DIC)?

How does acute disseminated intravascular coagulation (DIC) occur as a complication of pregnancy?

When is clinically significant disseminated intravascular coagulation (DIC) likely to occur?

How do vascular disorders lead to disseminated intravascular coagulation (DIC)?

How is the Japanese Association for Acute Medicine (JAAM) diagnostic criteria used to predict mortality in disseminated intravascular coagulation (DIC)?

What are complications of disseminated intravascular coagulation (DIC)?

What is the prevalence of disseminated intravascular coagulation (DIC)?

What is the prognosis and mortality rate of disseminated intravascular coagulation (DIC)?

What is the prognosis of disseminated intravascular coagulation (DIC)?

What do histologic studies in patients with disseminated intravascular coagulation (DIC) reveal?

What has been reported in experimental animal studies of disseminated intravascular coagulation (DIC)?

How much does disseminated intravascular coagulation (DIC) increase mortality in patients with sepsis and severe trauma?

Presentation

What are the signs and symptoms of disseminated intravascular coagulation (DIC)?

What history suggests disseminated intravascular coagulation (DIC) and how does acutely presenting DIC manifest?

What is the presentation of disseminated intravascular coagulation (DIC)?

Which physical findings suggest disseminated intravascular coagulation (DIC) and what is the presentation of chronic or subacute DIC?

What are the hematologic signs of disseminated intravascular coagulation (DIC)?

What are the central nervous system signs of disseminated intravascular coagulation (DIC)?

What are the cardiovascular signs of disseminated intravascular coagulation (DIC)?

What are the respiratory signs of disseminated intravascular coagulation (DIC)?

What are the GI signs of disseminated intravascular coagulation (DIC)?

What are the genitourinary signs of disseminated intravascular coagulation (DIC)?

What are the dermatologic signs of disseminated intravascular coagulation (DIC)?

DDX

Which conditions should be included in the differential diagnosis of disseminated intravascular coagulation (DIC)?

How is thrombotic thrombocytopenic purpura (TTP)-hemolytic uremic syndrome (HUS) differentiated from disseminated intravascular coagulation (DIC)?

How is immune thrombocytopenic purpura (ITP) differentiated from disseminated intravascular coagulation (DIC)?

How is heparin-induced thrombocytopenia and thrombosis syndrome (HITTS) differentiated from disseminated intravascular coagulation (DIC)?

What are the differential diagnoses for Disseminated Intravascular Coagulation?

Workup

How is disseminated intravascular coagulation (DIC) diagnosed?

Which lab test findings suggest disseminated intravascular coagulation (DIC)?

What are the limitations of lab testing in the workup of disseminated intravascular coagulation (DIC)?

Which lab tests are performed in the workup of disseminated intravascular coagulation (DIC)?

What is the role of platelet count in the workup of disseminated intravascular coagulation (DIC)?

What is the role of global clotting times and coagulation factors in the workup of disseminated intravascular coagulation (DIC)?

What is the role of soluble fibrinogen measurement in the workup of disseminated intravascular coagulation (DIC)?

What is the role of D-dimer and fibrin degradation product (FDP) tests in the workup of disseminated intravascular coagulation (DIC)?

What are the most sensitive assays for the diagnosis of disseminated intravascular coagulation (DIC)?

What is the role of activation markers in the workup of disseminated intravascular coagulation (DIC)?

What are the limitations in availability of diagnostic tests for disseminated intravascular coagulation (DIC)?

What is the role of thrombomodulin testing in the workup of disseminated intravascular coagulation (DIC)?

What is the ISTH scoring system for the diagnosis of overt disseminated intravascular coagulation (DIC)?

How is the ISTH scoring system used to predict mortality rates in disseminated intravascular coagulation (DIC)?

What is the Japanese Association for Acute Medicine (JAAM) diagnostic algorithm and scoring system for disseminated intravascular coagulation (DIC)?

How has the Japanese Association for Acute Medicine (JAAM) diagnostic algorithm and scoring system for disseminated intravascular coagulation (DIC) been validated?

Which histologic findings support a diagnosis of disseminated intravascular coagulation (DIC)?

Treatment

What should be the focus of treatment of disseminated intravascular coagulation (DIC)?

What are the features of disseminated intravascular coagulation (DIC) management?

What is the role of heparin in the treatment of disseminated intravascular coagulation (DIC)?

What is the role of activated protein C (drotrecogin alfa) for the treatment of disseminated intravascular coagulation (DIC)?

What is the inpatient treatment for disseminated intravascular coagulation (DIC)?

How is the appropriate therapy selected for the treatment of disseminated intravascular coagulation (DIC)?

How is the severity of the coagulopathy and the effectiveness of treatment assessed in disseminated intravascular coagulation (DIC)?

When is platelet and coagulation factor replacement therapy indicated in the treatment of disseminated intravascular coagulation (DIC)?

When is platelet transfusion indicated in the treatment of disseminated intravascular coagulation (DIC)?

What is the threshold for platelet transfusion in the treatment of disseminated intravascular coagulation (DIC)?

What are the risks of coagulation factor replacement therapy for the treatment of disseminated intravascular coagulation (DIC)?

How is consumption-induced deficiency of coagulation factors corrected in the treatment of disseminated intravascular coagulation (DIC)?

Which tests are useful for monitoring the coagulation defect in disseminated intravascular coagulation (DIC) treatment?

What are the risks of heparin anticoagulation therapy for the treatment of disseminated intravascular coagulation (DIC)?

What is the role of low-molecular-weight heparin (LMWH) in the treatment of disseminated intravascular coagulation (DIC)?

What is the role of anticoagulation prophylaxis in the treatment of disseminated intravascular coagulation (DIC)?

What are the options for restoring anticoagulant pathways in the treatment of disseminated intravascular coagulation (DIC)?

What is the role of antithrombin replacement in the treatment of disseminated intravascular coagulation (DIC)?

What is the role of tissue factor pathway inhibitor (TFPI) in the treatment of disseminated intravascular coagulation (DIC)?

What is the role of recombinant thrombomodulin (rTM) in the treatment of disseminated intravascular coagulation (DIC)?

What is the focus of novel therapeutic strategies for disseminated intravascular coagulation (DIC)?

Which treatments for disseminated intravascular coagulation (DIC) are focused on the tissue factor (TF)-VIIa complex?

What is the role of recombinant factor VIIa (rVIIa) in the treatment of disseminated intravascular coagulation (DIC)?

What is the role of antifibrinolytic agents in the treatment of disseminated intravascular coagulation (DIC)?

What is the role of anti-inflammatory agents in the treatment of disseminated intravascular coagulation (DIC)?

What is the role of activated protein C concentrate in the treatment of disseminated intravascular coagulation (DIC)?

Which specialists should be consulted in the diagnosis and management of disseminated intravascular coagulation (DIC)?

What long-term monitoring is needed following treatment of disseminated intravascular coagulation (DIC)?

Medications

What are the goals of drug treatment in the management of disseminated intravascular coagulation (DIC)?

What is the basis for therapeutic decisions in the treatment of disseminated intravascular coagulation (DIC)?

Which medications in the drug class Antifibrinolytic Agents are used in the treatment of Disseminated Intravascular Coagulation?

Which medications in the drug class Blood Components are used in the treatment of Disseminated Intravascular Coagulation?

Which medications in the drug class Recombinant Human Activated Protein C are used in the treatment of Disseminated Intravascular Coagulation?

Which medications in the drug class Anticoagulants, Hematologic are used in the treatment of Disseminated Intravascular Coagulation?