Disseminated intravascular coagulation

Disseminated intravascular coagulation (DIC), a syndrome characterized by systemic intravascular activation of coagulation with widespread fibrin deposition in the circulation, causes a hypercoagulable state, haemorrhagic symptoms and multiple organ failure. It is associated with a variety of clinical conditions. Recent studies have identified several pathogenic pathways involving thrombin generation, diminished physiological anticoagulant systems, increased endogenous fibrinolysis and endothelial dysfunction. A more accurate diagnosis of DIC can be made by the use of a scoring system based on the clinical background of the patient combined with a number of simple laboratory tests. The cornerstone of the management of a patient with DIC is the specific and aggressive treatment of the underlying disease. Novel therapeutic approaches aimed at inhibition of tissue factor mediated activation of coagulation and restoration of physiological anticoagulant pathways need further evaluation. An improved understanding and earlier diagnosis could lead to targeted treatment and improved prognosis.