In disseminated intravascular coagulation, what is the mechanism by which heparin can be beneficial?

• A. Decreases microclot formation
• B. Increases synthesis of clotting factors
• C. Inhibits platelet production
• D. Promotes bleeding

Answer: (A)

In DIC, widespread activation of the coagulation system causes many small clots to form (microthrombi) while clotting factors and platelets are consumed, which can lead to both clotting-related organ damage and bleeding. Heparin helps by enhancing the activity of antithrombin III, which inhibits thrombin and factor Xa. This dampens the coagulation cascade, reduces fibrin formation, and decreases the ongoing formation of microthrombi. By slowing these clots, it helps limit organ injury and further consumption of clotting factors, though it’s used only when thrombosis is the dominant issue and bleeding risk is manageable. It does not increase synthesis of clotting factors, stop platelet production, or promote bleeding as the therapeutic mechanism.