Key messages

• The hemostatic system is carefully balanced and controlled so that inappropriate bleeding or thrombosis does not occur.

• Normal hemostasis is an interaction between circulating platelets, coagulation factors, the vascular endothelial cell, the fibrinolytic system, and various inhibitory pathways.

• Acute disseminated intravascular coagulation is a major breakdown in the hemostatic process mediated mainly by excessive tissue factor expression and cytokine generation.

• Rapid assessment of the hemostatic process and appropriate therapeutic intervention is dependent on a thorough understanding of these various pathways.

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