Iba Toshiaki, Helms Julie, Levy Jerrold H
Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan.
Medical Intensive Care Unit - NHC, Strasbourg University (UNISTRA), Strasbourg University Hospital, INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France.
Ann Intensive Care. 2024 Sep 20;14(1):148. doi: 10.1186/s13613-024-01380-5.
The mortality rate of sepsis remains high and further increases when complicated by disseminated intravascular coagulation (DIC). Consequently, early detection and appropriate management of DIC will be helpful for the management of sepsis. Although overt DIC criteria are often used for diagnosing definitive DIC, it was not designed to detect early-phase DIC. The criteria and scoring system for sepsis-induced coagulopathy (SIC) were developed and introduced in 2017 to detect early-stage DIC, and they were subsequently adopted by the International Society on Thrombosis and Haemostasis in 2019. The objective of detecting SIC was not to miss the patients at high risk of developing overt DIC at an earlier time. Although anticoagulant therapies are potential options for the treatment of sepsis-associated DIC, their effectiveness has not been established, and further research is warranted. For that purpose, an international collaborative platform is required for future clinical trials, and SIC criteria have been suggested for such studies. Calculating the SIC score is straightforward and suitable for use in clinical settings. This review aims to introduce SIC criteria and its scoring system for better management of sepsis-associated DIC. We also intended to update the current knowledge regarding this novel diagnostic criterion.
脓毒症的死亡率仍然很高，当并发弥散性血管内凝血（DIC）时死亡率会进一步上升。因此，早期发现并妥善处理DIC将有助于脓毒症的治疗。虽然显性DIC标准常被用于诊断确诊的DIC，但它并非用于检测早期DIC而设计。脓毒症诱导的凝血病（SIC）的标准和评分系统于2017年制定并推出，用于检测早期DIC，随后在2019年被国际血栓与止血学会采用。检测SIC的目的是避免遗漏那些在更早阶段有发展为显性DIC高风险的患者。虽然抗凝治疗是脓毒症相关性DIC治疗的潜在选择，但其有效性尚未确立，仍需进一步研究。为此，未来的临床试验需要一个国际协作平台，并且已针对此类研究提出了SIC标准。计算SIC评分很简单，适用于临床环境。本综述旨在介绍SIC标准及其评分系统，以便更好地管理脓毒症相关性DIC。我们还打算更新有关这一新诊断标准的现有知识。
