Loading...
Please wait, while we are loading the content...
Similar Documents
Supportive management strategies for disseminated intravascular coagulation. An international consensus.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Squizzato, Alessandro Hunt, Beverley J. Kinasewitz, Gary T. Wada, Hideo Cate, Hugo Ten Thachil, Jecko V. Levi, Marcel Vicente, Vicente D'angelo, Armando Nisio |
| Copyright Year | 2015 |
| Abstract | The cornerstone of the management of disseminated intravascular coagulation (DIC) is the treatment of the underlying condition triggering the coagulopathy. However, a number of uncertainties remain over the optimal supportive treatment. The aim of this study was to provide evidence and expert-based recommendations on the optimal supportive haemostatic and antithrombotic treatment strategies for patients with DIC. A working group defined five relevant clinical scenarios. Published studies were systematically searched in the MEDLINE and EMBASE databases (up to May 2014). Seven internationally recognised experts were asked to independently provide clinical advice. A two-phase blinded data collection technique was used to reach consensus. Only three randomised controlled trials (RCTs) on the supportive management of DIC were identified. The RCTs (overall less than 100 patients) investigated the use of fresh frozen plasma and platelet transfusion and found no differences in survival between the intervention and control groups. The experts' approach was heterogeneous, although there was consensus that supportive management should vary according to the underlying cause, clinical manifestations and severity of blood test abnormalities. Platelet transfusion should be given to maintain platelet count > 50×10⁹/l in case of bleeding while a lower threshold of 20 to 30×10⁹/l may be used in DIC without bleeding. Thromboprophylaxis with low-molecular-weight heparin is advised until bleeding ensues or platelet count drops below 30×10⁹/l. In conclusion, in the absence of solid evidence from RCTs, an individualised supportive management of DIC is advisable based on the type of underlying disease, presence of bleeding or thrombotic complications and laboratory tests results. |
| Starting Page | 896 |
| Ending Page | 904 |
| Page Count | 9 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://th.schattauer.de/en/contents/archive/issue/2338/manuscript/25389/download.html |
| PubMed reference number | 26676927v1 |
| Alternate Webpage(s) | https://doi.org/10.1160/TH15-09-0740 |
| DOI | 10.1160/TH15-09-0740 |
| Journal | Thrombosis and haemostasis |
| Volume Number | 115 |
| Issue Number | 5 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Blinded Blood Coagulation Disorders Blood Platelet Disorders Conflict (Psychology) Congenital Abnormality Data Collection Disseminated Intravascular Coagulation Genetic Heterogeneity Hematologic Tests Hematological Disease Hemorrhage Hemostatic Agents Hemostatic function Heparin, Low-Molecular-Weight Laboratory Procedures Patients Platelet Transfusion Thrombosis Thrombotic Microangiopathies heparin |
| Content Type | Text |
| Resource Type | Article |
