New biomolecules for the treatment of Disseminated Intravascular Coagulation

Disseminated intravascular coagulation (DIC) is a clotting disorder characterized by a hypercoagulation state that can lead to multiple organ failure as a final complication. There are two forms of DIC, acute and chronic. It is usually determined by the exposure of the tissue factor and the activation of the extrinsic pathway of coagulation cascade. DIC often appears as a complication of sepsis, trauma, obstetrical emergencies and neoplastic conditions. Acute DIC includes symptoms such as bleeding, hepatic, kidney or respiratory failure, while chronic DIC associates thrombotic complications. For paraclinical diagnosis, the International Society on Thrombosis and Haemostasis uses a lab score that includes platelet count, fibrinogen, PT, D Dimers values. This score is not 100% specific so differential diagnosis should be made. The therapeutic approach requires life functions supervision, control of hemorrhage and thrombosis with new supportive strategies, antibiotherapy for septic patients and surgical intervention if needed. New strategies aimed at the inhibition of coagulation activation using biomolecules are available. Management of thrombotic, hemorrhagic or septic patients requires a multidisciplinary team, involving ICU doctors, hematological specialists, biomedical researchers, surgeons and the availability of a Blood Transfusion Centre.