Schematic representation of pathogenetic pathways in DIC.

During systemic inflammatory response syndromes, both perturbed endothelial cells and activated mononuclear cells may produce proinflammatory cytokines that mediate coagulation activation. Activation of coagulation is initiated by tissue factor expression on activated mononuclear cells and endothelial cells. In addition, downregulation of physiological anticoagulant mechanisms and inhibition of fibrinolysis by endothelial cells will further promote intravascular fibrin deposition. PAI-1 indicates plasminogen activator inhibitor, type 1.