Expert consensus for the treatment of disseminated intravascular coagulation in Japan.
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.
Wada
Hideo
H
Department of Molecular and Laboratory Medicine, Mie University School of Medicine, 2-174, Edobashi, Tsu, Mie-ken 514-8507, Japan. wadahide@clin.medic.mie-u.ac.jp
Asakura
Hidesaku
H
Okamoto
Kohji
K
Iba
Toshiaki
T
Uchiyama
Toshimasa
T
Kawasugi
Kazuo
K
Koga
Shin
S
Mayumi
Toshihiko
T
Koike
Kaoru
K
Gando
Satoshi
S
Kushimoto
Shigeki
S
Seki
Yoshinobu
Y
Madoiwa
Seiji
S
Maruyama
Ikuro
I
Yoshioka
Akira
A
D000925:Anticoagulants / Q000627:therapeutic use*; D032921:Consensus; D004211:Disseminated Intravascular Coagulation / Q000628:therapy*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D007564:Japan; D015842:Serine Proteinase Inhibitors / Q000627:therapeutic use*; D012955:Societies, Medical
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D015842:Serine Proteinase Inhibitors