Disseminated intravascular coagulation
The ISTH 2025 definition and scores, the bleeding and thrombotic phenotypes, how to separate DIC from TTP, liver disease and snakebite coagulopathy, and when to give platelets, plasma, cryoprecipitate or heparin.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- DIC is always secondary: sepsis, trauma, obstetric catastrophe, malignancy. Treating the cause is the treatment.
- The ISTH 2025 update defines DIC as an acquired, life-threatening disorder of systemic coagulation activation, with dysregulated fibrinolysis, endothelial injury and microthrombosis. It splits DIC into pre-DIC, early-phase and overt DIC.
- No single test diagnoses it. Use serial platelets, PT, fibrinogen and D-dimer, scored with the ISTH overt DIC score or, in sepsis, the SIC score.
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Sources
- Updated definition and scoring of disseminated intravascular coagulation in 2025: communication from the ISTH SSC Subcommittee on Disseminated Intravascular CoagulationIba T et al., J Thromb Haemost 2025;23:2356-62, 2025
- Introducing the new definition and diagnostic criteria of disseminated intravascular coagulation released by the International Society on Thrombosis and Haemostasis in 2025Iba T et al., Semin Thromb Hemost 2026;52:10-17, 2026
- Guidance for diagnosis and treatment of DIC from harmonization of the recommendations from three guidelinesWada H et al., J Thromb Haemost 2013;11:761-7, 2013
- Guidelines for the diagnosis and management of disseminated intravascular coagulationLevi M et al., British Committee for Standards in Haematology, Br J Haematol 2009;145:24-33, 2009
- Patient blood management guideline for adults with critical bleedingAU/NZNational Blood Authority, 2023, minor update September 2025
- Adult cryoprecipitate dosing informationAU/NZVictorian Department of Health, Blood Matters, 29 June 2026
- Safety Notice SN:004/26: changes to adult cryoprecipitate doses, implications for major haemorrhage protocolsAU/NZNSW Health, 2026
- Effect of a recombinant human soluble thrombomodulin on mortality in patients with sepsis-associated coagulopathy: the SCARLET randomized clinical trialVincent JL et al., JAMA 2019;321:1993-2002, 2019
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback