الفهرس 
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Abstract
Summary
he International Society on Thrombosis and Hemostasis
has suggested the following definition for DIC: “An
acquired syndrome characterized by the intravascular activation
of coagulation with loss of localization arising from different
causes. It can originate from and cause damage to the
microvasculature, which if sufficiently severe, can produce
organ dysfunction.”
DIC is estimated to be present in as many as 1% of
hospitalized patients. DIC is not itself a specific illness; rather, it
is a complication or an effect of the progression of other illnesses.
It is always secondary to an underlying disorder and is associated
with a number of clinical conditions, generally involving
activation of systemic inflammation. Most common conditions
include (Sepsis and severe infection - Trauma (neurotrauma) -
Obstetric complications (amniotic fluid embolism; hemolysis,
elevated liver enzymes, low platelets (HELLP) syndrome;
eclampsia; Retained dead fetus syndrome).
Disseminated intravascular coagulation (DIC) is
categorized into bleeding, organ failure, massive bleeding, and
non-symptomatic types according to the sum of vectors for
hypercoagulation and hyperfibrinolysis. The British Committee
for Standards in Hematology, Japanese Society of Thrombosis
and Hemostasis, and the Italian Society for Thrombosis and
Hemostasis published separate guidelines for DIC; however,
there are several differences between these three sets of
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Summary
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guidelines. Therefore, the International Society of Thrombosis
and Hemostasis (ISTH) recently harmonized these differences
and published the guidance of diagnosis and treatment for DIC.
Treatment of underlying conditions is recommended in
three types of DIC, with the exception of massive bleeding.
Blood transfusions are recommended in patients with the
bleeding and massive bleeding types of DIC. Meanwhile,
treatment with heparin is recommended in those with the nonsymptomatic
type of DIC. The administration of synthetic
protease inhibitors and antifibrinolytic therapy is recommended
in patients with the bleeding and massive bleeding types of
DIC. Furthermore, the administration of natural protease
inhibitors is recommended in patients with the organ failure
type of DIC, while antifibrinolytic treatment is not. The
diagnosis and treatment of DIC should be carried out in
accordance with the type of DIC.