The present report from The Japanese Society of
Thrombosis and Hemostasis provides an expert consensus for the treatment of
disseminated intravascular coagulation (
DIC) in Japan.
Disseminated intravascular coagulation (
DIC) may be classified as follows: asymptomatic type, marked
bleeding type, and organ failure type. Although treatment of
DIC is important, adequate treatment differs according to type of
DIC. In asymptomatic
DIC,
low molecular weight heparin (
LMWH), synthetic
protease inhibitor (SPI), and
antithrombin (AT) are recommended, although these drugs have not yet been proved to have a high degree of effectiveness.
Unfractionated heparin (UFH) and
danaparoid sodium (DS) are sometimes administrated in this type, but their usefulness is not clear. In the marked
bleeding type,
LMWH, SPI, and AT are recommended although these drugs do not have high quality of evidence.
LMWH, UFH, and DS are not recommended in case of life threatening
bleeding. In case of severe
bleeding, SPI is recommended since it does not cause a worsening of
bleeding.
Blood transfusions, such as fresh frozen plasma and platelet concentrate, are also required in cases of life threatening
bleeding. In the organ failure type, including
sepsis, AT has been recommended based on the findings of several clinical trials.
DIC is frequently associated with
thrombosis and may thus require strong
anticoagulant therapy, such as
LMWH, UFH, and DS.