Acute DIC is a medical emergency and is always aimed towards eliminating the precipitating trigger (if possible) and treating any associated issues, such as infection or acidosis. Specialist advice is recommended.
In the presence of widespread bleeding, specific replacement with blood component therapy should be given.
Blood Component Therapy in Disseminated Intravascular Coagulation
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When there is bleeding and abnormal coagulation
- Usually 4 units (10–15 mL/kg) are rapidly infused
- Is not indicated for chronic DIC
- This contains fibrinogen in a concentrated form
- Fibrinogen deficiency is commonly encountered in DIC
- May be indicated at fibrinogen levels lower than 1.0 g/L and where there is clinical bleeding
- Use to keep fibrinogen levels above 1.0 g/L
- May be appropriate when clinical bleeding and thrombocytopenia are considered major contributory factors
- Usually 1–2 adult doses should be given
- Antithrombin (Thrombotrol-VF) replacement has also been used in some patients
- May have a role in the management of those patients who do not respond to simple replacement therapy of blood components
- Consult with a haematologist
Following initial replacement therapy, laboratory tests should be repeated. Any further treatment is guided by both clinical and laboratory responses.
Prothrombinex-VF is contraindicated as it may potentiate existing thrombotic tendency, which is a feature of patients with DIC. The role of heparin is controversial.