Part 1: Disseminated Intravascular Coagulation

Thomas G. DeLoughery, MD, FACP

Dr. DeLoughery is a professor of medicine, Departments of Pathology and Pediatrics, Oregon Health Sciences University, Portland, OR.

Question 1

Given that the underlying mechanism of disseminated intravascular coagulation (DIC) is inappropriate activation of thrombin, treatment with an anticoagulant is appealing. However, antithrombin therapy should be strongly considered in only one of the following situations:

  •  A 6-year-old child with E. coli sepsis
  •  A 23-year-old woman with sudden shortness of breath
    and DIC after delivery
  •  A 47-year-old man with leg trauma receiving massive transfusion
  •  A 65-year-old man with lung cancer and a new
    femoral vein thrombosis
  •  A 78-year-old woman bitten by a rattlesnake on a nature walk

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