Severe Sepsis with DIC: Treatment of Disseminated Intravascular Coagulation When Platelet Count Is Not Below 30 × 10⁹/l

When disseminated intravascular coagulation develops in the setting of severe sepsis, management decisions depend critically on the patient's haemostatic profile — particularly platelet count. This protocol addresses the sub-population where platelets are not below the key safety threshold.

Clinical Scenario

Severe sepsis complicated by DIC, with a platelet count not below 30 × 10⁹/l. Patients whose platelet count falls below this level carry an elevated bleeding risk and are managed under a separate approach.

Treatment approach: Evidence supports the use of a recombinant human activated protein C-based intervention in eligible patients meeting this scenario. The complete administration protocol — including schedule, duration, and patient-selection criteria — is available in the full structured regimen.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1111/j.1365-2141.2009.07600.x

Consider treating patients with severe sepsis and DIC with recombinant human activated protein C (continuous infusion, 24 μg/kg/h for 4 d) (Grade A, Level Ib).
Patients at high risk of bleeding should not be given recombinant human activated protein C. Current manufacturers guidance advises against using this product in patients with platelet counts of <30 × 10⁹/l.

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