DIC: Which laboratory tests are most useful

In patients with disseminated intravascular coagulation (DIC) a variety of altered coagulation parameters may be detectable, such as thrombocytopenia, prolonged global coagulation times, reduced levels of coagulation inhibitors, or high levels of fibrin split products. In addition, more sophisticated tests for activation of individual factors or pathways of coagulation may point to specific involvement of these components in the pathogenesis of the disorder. There is not a single test, however, that is sufficiently accurate to establish or reject a diagnosis of DIC. Nevertheless, a combination of widely available tests may be helpful in making the diagnosis of DIC and can also be helpful to guide in the selection of DIC patients that require specific, often expensive, interventions in the coagulation system. More recently developed dynamic algorithms, assessing changes in coagulation parameters over sequential days, could further increase the diagnostic accuracy for DIC and may be helpful to detect early stages of coagulopathy potentially evolving into DIC. (C) 2010 Elsevier Ltd. All rights reserved.