ICU SAQs · Haematology / coagulation
Septic DIC — bleeding, thrombosis, and the management
A CICM SAQ on septic DIC — the 2025 ISTH overt-DIC score, treating the underlying condition, transfusion for bleeding, and the limited role of antifibrinolytics and anticoagulant concentrates.
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Prompt
A 60-year-old with urosepsis is oozing from IV sites. Platelets 40 x10^9/L, PT prolonged by 8 seconds, fibrinogen 0.9 g/L, D-dimer more than 7 times the upper normal limit. Outline the diagnosis and management.
Question
A 60-year-old with urosepsis is oozing from IV sites. Platelets 40 ×10^9/L, PT prolonged by 8 seconds, fibrinogen 0.9 g/L, D-dimer more than 7 times the upper normal limit. Outline the diagnosis and management.[1]
References5ShowHide
- [1]Iba T, Levy JH, Maier CL, et al. Updated definition and scoring of disseminated intravascular coagulation in 2025: communication from the ISTH SSC Subcommittee on Disseminated Intravascular Coagulation. Journal of thrombosis and haemostasis : JTH, 2025.PMID 40216223
- [2]Bakhtiari K, Meijers JC, de Jonge E, et al. Prospective validation of the International Society of Thrombosis and Haemostasis scoring system for disseminated intravascular coagulation. Critical care medicine, 2004.PMID 15599145
- [3]Wada H, Thachil J, Di Nisio M, et al. Guidance for diagnosis and treatment of DIC from harmonization of the recommendations from three guidelines. Journal of thrombosis and haemostasis : JTH, 2013.PMID 23379279
- [4]Levi M, Toh CH, Thachil J, et al. Guidelines for the diagnosis and management of disseminated intravascular coagulation. British Committee for Standards in Haematology. British journal of haematology, 2009.PMID 19222477
- [5]Vincent JL, Francois B, Zabolotskikh I, et al. Effect of a Recombinant Human Soluble Thrombomodulin on Mortality in Patients With Sepsis-Associated Coagulopathy: The SCARLET Randomized Clinical Trial. JAMA, 2019.PMID 31104069