Disseminated intravascular coagulation for paediatricians: the whats, whys and hows

Disseminated intravascular coagulation (DIC) is a rare but life-threatening syndrome in children associated with severe disease states and poor outcomes. It is brought about by a complex interplay between the coagulation and inflammatory systems as an endpoint to multiple coagulopathy phenotypes. It has no gold standard test or therapy, making it challenging to diagnose and even harder to treat effectively. Most healthcare professionals working with children will only rarely encounter DIC, but given its significance, it is important to have a reference which makes this entity understandable to those inexperienced in its management. This article reviews DIC for this purpose, aiming to provide a concise and useful tool to help recognise and manage children presenting with DIC. This article also shines a light on what is not known. Much of the paediatric data and recommendations are extrapolated from adult patients which leaves fertile avenues for future research and refinement of practice.