Disseminated intravascular coagulation future or investigational therapies

• Phase I trials suggest that infusion of activated protein C may also benefit patients with DIC.

  • The theory is that APC normally inactivates Va and VIIIa, resulting in a decrease in thrombin formation, and promotes fibrinolysis by inactivating plasminogen activator inhibitor.

• Tissue factor pathway inhibitor has been shown to decrease mortality in baboon models of DIC with E. coli septic shock.
• Agents such as ASA (aspirin), ticlopidine, dextran and GP IIb/IIIa inhibitors are also being examined with the goal of reducing platelet activation.
• Currently, if fibrinolysis and hemorrhage appears to be more of a problem than clotting, the only options are antifibrinolytic agents, such as tranexamic acid. However, the risks of microvascular clot formation have limited its use.

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