Key messages

• Most cases of disseminated intravascular coagulation (DIC) in the intensive care setting are due to sepsis.

• DIC typically manifests as hemorrhage, thrombosis, and/or a typical pattern of abnormalities in laboratory coagulation tests.

• DIC may need to be differentiated from liver disease, vitamin K deficiency, thrombotic thrombocytopenic purpura, and certain postoperative states.

• The essentials of management include the identification and treatment of the underlying cause, the correction of hypoxia, and the maintenance of adequate tissue perfusion.

• Replacement of platelets and/or coagulation factors should be reserved for patients who are bleeding and those who are to undergo surgical intervention.

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