Because DIC is most likely to occur in patients who are already critically ill from some other disorder, it is not uncommon in the intensive care unit. The wide variation in causes and clinical manifestations has meant that controlled trials of therapy would be extremely problematical. Recognition of the clinical onset of the syndrome, and prompt treatment of the underlying ‘trigger’ should be combined with vigorous supportive therapy, until the precipitating cause is under control. Decisions regarding other forms of therapy, e.g. heparin and fibrinolytic agents, must take into account the individual problems of each patient. With these measures, an otherwise fatal outcome may well be avoided.