In summary, this series of 48 patients with acute and chronic
DIC demonstrates the reliability of laboratory tests in both aiding a diagnosis of
DIC and in offering reasonable predictability of efficacy of
therapy, as noted by the correction of abnormalities after delivery of antiprocoagulant
therapy for this syndrome. It appears that the diagnostic tests most likely to aid in diagnosis and to reliably inform the clinician when the intravascular clotting process has been stopped are those that determine the
antithrombin-III level, the presence of soluble
fibrin monomer, and the finding of elevated
fibrin(
ogen) degradation products,
thrombocytopenia and a prolonged thrombin time in the face of the appropriate type of
bleeding in the appropriate clinical setting. In addition, it would appear that mini-dose
heparin therapy is highly effective in controlling the intravascular clotting process in acute
DIC, whereas antiplatelet
therapy utilizing two agents is effective in chronic
DIC. In addition, in this population, patients with
acute disease demonstrated a 74 percent survival rate and those with
chronic disease had a 100 percent survival rate from the disseminated intravascular clotting process.