Laboratory Testing

• Increased D-dimer

• Thrombocytopenia

• Decreased fibrinogen

• Increased fibrin degradation products (FDP)

• Increased prothrombin time (PT)

• Evidence of end-organ dysfunction or failure

Heparin may be given IV or subcutaneously; there is no universally accepted dose. Heparin administered subcutaneously for venous thromboembolism prophylaxis (5,000 units every 8-12 hours) can be beneficial in DIC patients without serious or life-threatening bleeding. Full-dose heparin therapy in adults is a bolus of 5,000 units, followed by a continuous infusion of 1,000 units/h. In general, full-dose heparin should be avoided in patients with DIC due to increased risk of bleeding, and a lower dose of 500 units/hour can be used. Since the aPTT is already elevated in individuals with DIC, monitoring heparin therapy may be difficult. Treatment with subcutaneous

heparin and low-molecular weight heparins are other, less studied options.

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