Abstract
Disseminated intravascular coagulation (DIC) is a thrombo-hemorrhagic condition that commonly accompanies life-threatening illnesses in children and is associated with significant morbidity and mortality. Treatment of underlying conditions, hemodynamic support, and replacement therapy with blood components is the mainstay of DIC management. Limited research studies have supported the use of antithrombin (AT), recombinant thrombomodulin (rTM), and protein C concentrates (PrCC). Although there have been several studies and advancements in the DIC treatment in adults, data in pediatric patients are limited, and the consensus is lacking. Evidence validating the use of diagnostic scoring systems in the pediatric population is also limited. Since the hemostatic system differs significantly in children, especially in neonates, management of DIC is also different in children from that of adults, and there is a dire need for good quality research studies in this aspect.We reviewed more than 100 articles in PubMed, Cochrane database, and Google Scholar. This traditional review article discusses different scoring systems for diagnosing DIC in pediatric patients, and different pharmacological treatment options for acute DIC in this population. This study mainly focuses on papers published from 1990 to 2021 and includes papers in all languages involving humans only.
Highlights
BackgroundDisseminated intravascular coagulation (DIC) is an acquired clinicopathological syndrome that complicates various illnesses, mainly sepsis, trauma, malignancy, liver diseases, and toxins
Over the past few decades, several studies have demonstrated the efficacy of antithrombin (AT) and protein C concentrates (PrCC), recombinant activated protein C (APC), and recombinant thrombomodulin for the management of DIC in children [2,3]
High-quality studies in disseminated intravascular coagulation (DIC) diagnosis or management are limited in the pediatric population
Summary
Disseminated intravascular coagulation (DIC) is an acquired clinicopathological syndrome that complicates various illnesses, mainly sepsis, trauma, malignancy, liver diseases, and toxins. Their study concluded a target AT activity of 90% of normal at three days of therapy [27] Another non-randomized multi-institutional prospective survey in 729 DIC patients (including 182 patients in the 15-64 years age group and two in
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