Coagulation Abnormalities in Critical Illness

Abstract

In critically ill patients coagulation abnormalities often occur. The most pronounced manifestation of these, caused by overwhelming activation of the coagulation system, is disseminated intravascular coagulation (DIC) which is also considered to be a component of the multiple organ dysfunction syndrome (MODS). There is no generally accepted definition of DIC but recently a working definition has been proposed [1]: “DIC is an acquired syndrome characterized by the activation of intravascular coagulation up to intravascular fibrin formation, which may be accompanied by secondary fibrinolysis or inhibited fibrinolysis”. DIC is not a disease entity but rather a syndrome which can complicate a large variety of clinical disorders mostly characterized by high morbidity and mortality. In general, DIC is therefore an indication of severe underlying disease. In critical illness acute, rather than chronic, low grade DIC may complicate the course of disease.