Disseminated Intravascular Coagulation
Description Diagnostic criteria Medicine management Referral ICD-10 code: D65 DESCRIPTION Complication of an underlying condition, e.g. severe sepsis that is characterized by widespread activation of the clotting cascade leading to consumption of platelets and clotting factors with generalized bleeding. DIAGNOSTIC CRITERIA Investigations Prolonged INR and PTT. Thrombocytopaenia. Decreased f
Description
Diagnostic criteria
Medicine management
Referral
ICD-10 code: D65
DESCRIPTION
Complication of an underlying condition, e.g. severe sepsis that is characterized by widespread activation of the clotting cascade leading to consumption of platelets and clotting factors with generalized bleeding.
DIAGNOSTIC CRITERIA
Investigations
- Prolonged INR and PTT.
- Thrombocytopaenia.
- Decreased fibrinogen.
- Increased D-dimers
- Repeat test for monitoring.
- Identify the cause.
MEDICINE MANAGEMENT
For low fibrinogen:
- Cryoprecipitate 1 unit/10kg.
For an abnormal INR or PTT:
- Fresh frozen plasma (FFP) or Freeze dried plasma (FDP), IV, 15 mL/kg over 20-30 minutes.
Active bleeding with low platelet:
- Apheresis platelet transfusion, IV, 5–10 mL/kg over 20 minutes.
No bleeding with low platelets:
- No platelet transfusion.
REFERRAL
All unresponsive cases to a regional hospital.
Standard Treatment Guidelines and Essential Medicines List for South Africa Paediatric Hospital_2023 edition_ Updated February 2025
Chapter 3: Blood and Blood Forming Organs, 3.11 Disseminated Intravascular Coagulation