pharmacological intervention
Last reviewed 01/2018
The following interventions have been proposed:
- heparin:
- may be beneficial in the chronic DIC and large vessel thrombosis associated with cancer; the APTT should be maintained at about twice normal
- other indications for heparin are not supported conclusively by good trial data
- natural inhibitors:
- animal models of DIC suggest that supplementation with antithrombin before endotoxin challenge was beneficial but this benefit was lost if the antithrombin was given after the endotoxin
- there is no good clinical data to support supplementation with natural coagulation inhibitors
- other inhibitors have been proposed but there is no good evidence to support any of them:
- hirudin, a leech-derived thrombin inhibitor, has little trial evidence of benefit
- tranexamic acid, an inhibitor of plasmin, is best avoided as thrombosis may be increased