DIC: which laboratory tests are most useful
Abstract
In patients with disseminated intravascular coagulation (DIC) a variety of altered coagulation parameters may be detectable, such as thrombocytopenia, prolonged global coagulation times, reduced levels of coagulation inhibitors, or high levels of fibrin split products. In addition, more sophisticated tests for activation of individual factors or pathways of coagulation may point to specific involvement of these components in the pathogenesis of the disorder. There is not a single test, however, that is sufficiently accurate to establish or reject a diagnosis of DIC. Nevertheless, a combination of widely available tests may be helpful in making the diagnosis of DIC and can also be helpful to guide in the selection of DIC patients that require specific, often expensive, interventions in the coagulation system. More recently developed dynamic algorithms, assessing changes in coagulation parameters over sequential days, could further increase the diagnostic accuracy for DIC and may be helpful to detect early stages of coagulopathy potentially evolving into DIC.
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The classic laboratory findings of DIC are low platelets, prolonged PT and aPTT, and low fibrinogen levels.
“The classic laboratory findings of DIC are low platelets, prolonged PT and aPTT, and low fibrinogen levels.”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [99]
DIC may be suspected based on clinical presentation and laboratory findings, but no single laboratory test is sufficient to make the diagnosis.
“DIC may be suspected based on clinical presentation and laboratory findings, but no single laboratory test is sufficient to make the diagnosis (99).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [99]
Prolongation of the PT and PTT may be a relatively late finding; these tests become prolonged when there is depletion of more than 50% of clotting factors, and clinical bleeding may occur when depletion is >50-75%.
“Prolongation of the PT and PTT may be a relatively late finding; these tests become prolonged when there is depletion of more than 50% of clotting factors, and clinical bleeding may occur when depletion is >50–75% (99).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [99]
Clinically significant DIC may have normal or mildly reduced fibrinogen levels as it is an acute phase reactant, which limits its sensitivity as test for DIC severity.
“Clinically significant DIC may have normal or mildly reduced fibrinogen levels as it is an acute phase reactant, which limits its sensitivity as test for DIC severity (99).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [99]
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References 80 · Cited by 146
- Authors
- Levi, M., & Meijers, J. C.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Levi, Marcel
- Venue
- Blood Reviews
- Publisher
- Elsevier BV
- Published
- 2011-01
- Volume
- 25
- Issue
- 1
- Pages
- 33-37
- ISSN
- 0268-960X (ISSN-L)
- OpenAlex
- W2124432833
- Cited by
- 146
- References
- 80
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 8 · 2023: 9 · 2022: 4 · 2021: 15 · 2020: 15 · 2019: 3 · 2018: 10 · 2017: 8 · 2016: 15 · 2015: 12 · 2014: 10 · 2013: 10 · 2012: 10
- FWCI
- 5.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Blood Reviews (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Trauma, Hemostasis, Coagulopathy, Resuscitation
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Blood properties and coagulation
- Keywords
- disseminated intravascular coagulation, coagulation tests, thrombocytopenia, prothrombin time, activated partial thromboplastin time, anticoagulants, fibrinogen degradation products, coagulation factor activation, diagnostic accuracy
- MeSH terms
- Blood Coagulation Tests, Disseminated Intravascular Coagulation, Fibrin Fibrinogen Degradation Products, Humans, Biomarkers
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