TY - JOUR
T1 - Expert consensus for the treatment of disseminated intravascular coagulation in Japan
AU - Wada, Hideo
AU - Asakura, Hidesaku
AU - Okamoto, Kohji
AU - Iba, Toshiaki
AU - Uchiyama, Toshimasa
AU - Kawasugi, Kazuo
AU - Koga, Shin
AU - Mayumi, Toshihiko
AU - Koike, Kaoru
AU - Gando, Satoshi
AU - Kushimoto, Shigeki
AU - Seki, Yoshinobu
AU - Madoiwa, Seiji
AU - Maruyama, Ikuro
AU - Yoshioka, Akira
N1 - Funding Information:
The making of an expert consensus was supported by JSTH. We thank The Japanese Association for Infectious Diseases, The Japanese Society of Intensive Care Medicine and The Japanese Association for Acute Medicine for evaluation of this expert consensus.
PY - 2010/1
Y1 - 2010/1
N2 - 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.
AB - 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.
KW - DIC
KW - guideline
KW - recommendation
KW - sepsis
KW - treatment
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U2 - 10.1016/j.thromres.2009.08.017
DO - 10.1016/j.thromres.2009.08.017
M3 - Review article
C2 - 19782389
AN - SCOPUS:76449097783
VL - 125
SP - 6
EP - 11
JO - Thrombosis Research
JF - Thrombosis Research
SN - 0049-3848
IS - 1
ER -