Consumption Coagulopathy. Practical Principles of Diagnosis and Management.

Consumption Coagulopathy CC, produced by multiple etiologies, is a common mechanism of death. CC, properly diagnosed and managed, often results in the extension of life over several days, yielding sufficient time for the diagnosis and treatment of the underlying disorder. With the correction of the primary disease, the threat of CC will spontaneously remit. Determination of the type of CC is critical since it may be lethal if the wrong treatment--according to type--is used. A short panel of simple tests periodically repeated and suitable for hospital laboratories will produce patterns of differential diagnostic and therapeutic significance. In CC, the central principle of pathophysiology is the intravascular conversion of plasma to serum or mimetic serum. The central principle of therapy is the intravascular reversion of serum to plasma by the titration of the patient with continuous intravenous administration of the indicated drug, dosages being determined by the response of individual coagulation parameters in a periodically repeated standard panel. The physician, and especially the pathologist, because of his pivotal role in the diagnosis and management, must understand these concepts thoroughly. A practical operational approach is proposed to achieve these ends. Author