Disseminated intravascular coagulation
ICD-10 D65 · ICD-11 3B20

DIC Management in Severe Sepsis When Platelet Count Is Not Below 30 × 10⁹/l

This protocol targets patients with severe sepsis complicated by disseminated intravascular coagulation (DIC), specifically in those whose platelet count is not below 30 × 10⁹/l — a threshold that defines eligibility and separates this population from patients at the highest bleeding risk, for whom this approach is contraindicated.

Identifying this sub-group precisely matters: current guidance explicitly advises against a key intervention in patients with platelet counts falling below that threshold.

Treatment direction In this specific setting — severe sepsis with DIC and adequate platelet count — a recombinant activated protein C-based therapy may be considered. The complete regimen, administration details, and graded evidence summary are contained in the full protocol.
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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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