title: [Scoring of disseminated intravascular coagulation (DIC) in intensive care medicine].
abstract: A close association between disseminated intravascular coagulation (DIC) and increased morbidity and mortality of the critically ill has been uncovered in the ongoing validation of newly developed scoring systems of DIC. DIC scoring aims at quantifying and standardizing pathological activation of coagulation in these patients. Because of the high predictive power of DIC scoring for morbidity and mortality, early identification of DIC may play an important role in the management of critical illness by widening of the therapeutic window before development of irreversible organ failure. Therapeutic intervention in DIC is not well studied. Promising data on targeted modification of DIC by administration of antithrombin has been reported in the past, however, randomized controlled trials on the use of antithrombin for the treatment of DIC are still few. Early detection of DIC by application of novel scores could play a particular role in future DIC trials by defining patient populations most likely to benefit from targeted intervention in their clotting disturbance of critical illness.
authors.affiliation: Department of Internal Medicine, Central Hospital of Bolzano, Lorenz-Böhler-Street 5, 39100 Bolzano (BZ), Italy. christian.wiedermann@asbz.it
authors.forename: C J
authors.initials: CJ
authors.lastname: Wiedermann
authors.forename: M
authors.initials: M
authors.lastname: Egi
mesh_terms: D003422:Critical Care / Q000379:methods* / Q000592:standards; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D042241:Early Diagnosis; D004730:Endothelium, Vascular / Q000503:physiopathology; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D007249:Inflammation / Q000097:blood; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D018579:Patient Selection; D011446:Prospective Studies; D011486:Protein C / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000627:therapeutic use; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy
chemical_list: D005343:Fibrinolytic Agents; D011486:Protein C; D011994:Recombinant Proteins; C421124:drotrecogin alfa activated