The Elusive Diagnosis of Disseminated Intravascular Coagulation: Does a Diagnosis of DIC Exist Anymore?

摘要

Disseminated intravascular coagulation (DIC) is an intermediary mechanism of disease known to develop as a complication in other conditions like sepsis, trauma, cancer, or obstetrical disorders. Patients with DIC may present to different specialists depending on symptomology and as such a good understanding of the pathophysiological process is necessary to ensure best management. However, more recently, controversy has risen where experts doubt whether DIC really exists in many of the historically well-established diagnoses. This has led to confusion among both basic science researchers and clinical practitioners about when to consider DIC diagnosis. In this review, the various issues which have led to this uncertainty are addressed, including the problem with different terminologies, simpler explanation of current DIC diagnostic criteria, and reasons behind why the diagnosis may be overlooked or not considered at all, along with their possible solutions. It is hoped that the diagnostic aspects of DIC will come full circle, wherein the recent research can build up on what history had taught us and not refute its existence.