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Disturbances and Modulators of Coagulation and Fibrinolysis in Sepsis

  • L. G. Thijs
Conference paper

Abstract

In patients with sepsis abnormalities in hemostatic variables indicating systemic activation of coagulation and early activation with subsequent inhibition of fibrinolysis, are common features [1-5]. The most important clinical manifestation of these processes is disseminated intravascular coagulation (DIC), which is characterized by generation and deposition of fibrin in the microvasculature with widespread microvascular thrombosis in various organ systems. The bipha- sic effect on the fibrinolytic system may result in impaired fibrin dissolution and aggravate the formation of microthrombi. There is evidence that DIC contributes to the development of (multiple) organ dysfunction and failure [3, 5]. In addition, depletion of coagulation proteins and platelets, mainly due to the extensive and ongoing coagulation activation, may induce severe bleeding complications [6]. The impressive extreme of the clinical spectrum of manifestations of DIC is purpura fulminans, which presents with hemorrhagic skin necrosis and peripheral gangrene and is most often seen in meningococcal sepsis [7].

Keywords

Septic Shock Tissue Factor Plasminogen Activator Inhibitor Disseminate Intravascular Coagulation Thrombin Generation 
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  • L. G. Thijs

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