Approche critique des critères diagnostiques de coagulation intravasculaire disséminée

Disseminated intravascular coagulation (DIC) is a systemic, generalised and uncontrolled activation of the coagulation system. This failure of the coagulation system often occurs together with failure of numerous other organs and participates in the multiorgan failure syndrome. There is currently no single marker for the diagnosis of DIC, which therefore relies upon the analysis of a combination of several hemostasis parameters. The International Society for Thrombosis and Hemostasis (ISTH) has recently proposed a score based on platelet count, prothrombin time, fibrinogen and fibrin degradation products. This score has been shown to correlate with mortality and organ dysfunction, and its use has gained widespread acceptance in published studies. Other scores computing the same variables or others and alternative approaches (such as activated partial thromboplastin time waveform analysis) are proposed but lack extensive validation.