Disseminated intravascular coagulation (DIC) is a pathological process involving global activation of hemostasis and the formation of soluble or insoluble fibrin within the circulation. It has many causes, but sepsis probably underlies at least half of all cases seen in the critical care setting. DIC may manifest as hemorrhage (90 per cent), widespread microvascular thrombosis with multiorgan dysfunction, or an incidental finding in laboratory coagulation tests. Its management is controversial, in part because of the large number of conditions with which it is associated (TableJ..) and a dearth of prospective clinical trials. A rational approach to therapy requires some understanding of its pathogenesis (Fig 1).
Table 1 Some clinical disorders that may be complicated by DIC.
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