Last reviewed: 12 Nov 2024
Last updated: 04 Nov 2021
Summary
Definition
History and exam
Key diagnostic factors
- presence of underlying disorders
- oliguria, hypotension, or tachycardia
- purpura fulminans, gangrene, or acral cyanosis
- delirium or coma
- petechiae, ecchymosis, oozing, or hematuria
Full details
Risk factors
- major trauma/burn/organ destruction or sepsis/severe infection
- severe obstetric disorders or complications
- solid tumors and hematologic malignancies
- severe toxic or immunologic reactions
- major vascular disorders (large aortic aneurysms or giant hemangiomas)
Full details
Diagnostic tests
1st tests to order
- platelet count
- prothrombin time (PT)
- fibrinogen
- D-dimer/fibrin degradation products
- activated partial thromboplastin time (aPTT)
- imaging studies or other tests
Full details
Tests to consider
- thrombin time
- factor V, VIII, X, XIII
Full details
Emerging tests
- inflammatory cytokines
- D-dimer (monoclonal antibody test)
- antithrombin III
- fibrinopeptide A (FPA)
- prothrombin fragment 1 and 2
Treatment algorithm
ACUTE
low bleeding risk
high bleeding risk or active bleeding
ONGOING
chronic DIC
Contributors
Authors
Haibo Wang, MD, PhD
Assistant Professor - Gratis
LSU Health Sciences Center Shreveport (LSUHSC-S)
Shreveport
LA
Staff Anesthesiologist
JPS Health Network
Department of Anesthesiology
Fort Worth
TX
Disclosures
HW declares that he has no competing interests.
Acknowledgements
Dr Haibo Wang would like to gratefully acknowledge Dr Frank G. Zavisca, a previous contributor to this topic.
Disclosures
FGZ declared he had no competing interests.
Peer reviewers
Alan Kaye, MD, PhD, DABPM
Professor and Chairman
Department of Anesthesiology
LSU School of Medicine
New Orleans
LA
Disclosures
AK is on the speakers' bureau of Baxter Corporation and Hospira Corporation.
Cheng-Hock Toh, MB, ChB, MD, FRCP, FRCPath
Professor of Haematology
University of Liverpool
Liverpool
UK
Disclosures
CHT is an author of a reference cited in this topic.
Differentials
- Severe liver failure
- Heparin-induced thrombocytopenia
- Idiopathic purpura fulminans
More DifferentialsGuidelines
- Management of cancer-associated disseminated intravascular coagulation: guidance from the SSC and ISTH
- Guidelines for the diagnosis and management of disseminated intravascular coagulation (amendment to recommendation for activated protein C)
More GuidelinesPatient information
Disseminated intravascular coagulation
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