Disseminated Intravascular Coagulation (DIC) - NYSORA | NYSORA

Disseminated Intravascular Coagulation (DIC)

Learning objectives

  • Recognize Disseminated Intravascular Coagulation (DIC)
  • Management of DIC

Definition and mechanisms

  • Disseminated Intravascular Coagulation is a life-threatening disease characterized by systemic activation of blood coagulation
  • Resulting in the generation and deposition of fibrin
  • Leading to microvascular thrombi in various organs and contributing to multiple organ dysfunction syndrome (MODS)
  • Consumption of clotting factors and platelets in DIC can result in life-threatening hemorrhage
  • Hence, a patient with DIC can present with a simultaneously occurring thrombotic and bleeding problem, obviously complicating the proper treatment
  • DIC affects about 10% of very ill patients with sepsis, cancer, or pancreatitis or patients recovering from traumatic injuries such as burns or serious complications from pregnancy and delivery

Signs and symptoms

  • Bleeding at wound sites or from the nose, gums, or mouth
  • Blood in the stool or urine
  • Bruising 
  • Chest pain
  • Pain, redness, warmth, and swelling of the leg
  • Confusion, memory loss, or change of behavior
  • Difficulty breathing
  • Fever


Major damage to organs or tissues
Severe injury
Major surgery
Severe immune reactionsFailed blood transfusion
Organ transplant rejection
Toxin: snake venom
Serious pregnancy-related problemsSeparation of the placenta from the uterus before delivery
Amniotic fluid in the bloodstream
Serious bleeding during or after delivery



International Society of Thrombosis and Hemostatis criteria
Clinical condition predisposing to DICEssential
The presence of clinical symptomsNot used
Platelet count (in x 109/L)50-100: 1 point
-50: 2 points
Fibrin-related markerModerate increase: 2 points
Marked increase: 3 points
Fibrinogen<1: 1 point
Prohtrombin time> 6: 2 points
DIC diagnosis≥ 5 points


Disseminated intravascular coagulation (DIC), anemia, normothermia, coagulation, fibrinogen, hemoglobin and platelets, PT/APTT ratio, fibrinogen, FFP, cryoprecipitate Phrothrombin

Suggested reading

  • Thachil J. Disseminated Intravascular Coagulation: A Practical Approach. Anesthesiology. 2016;125(1):230-236.
  • Ridley, S., Taylor, B., Gunning, K., 2007. Medical management of bleeding in critically ill patients. Continuing Education in Anaesthesia Critical Care & Pain 7, 116–121.

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