Sepsis, Coagulation, and Antithrombin: Old Lessons and New Insights

ABSTRACT Current insights in the pathogenesis of multiple organ dysfunction in patients with sepsis point to a pivotal role of inflammation and coagulation. One of the most important mechanisms contributing to the activation of coagulation in sepsis is the downregulation of physiologic anticoagulant...

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Veröffentlicht in:Seminars in thrombosis and hemostasis Jg. 34; H. 8; S. 742 - 746
Hauptverfasser: Levi, Marcel, Schouten, Marcel, van der Poll, Tom
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 01.11.2008
Schlagworte:
Anticoagulants - therapeutic use
Antithrombins - physiology
Antithrombins - therapeutic use
Blood Coagulation - physiology
Fibrinolytic Agents - therapeutic use
Humans
Sepsis - blood
Sepsis - drug therapy
antithrombin
Sepsis
thrombosis
coagulation
ISSN:0094-6176, 1098-9064, 1098-9064
Online-Zugang:Volltext
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Zusammenfassung:ABSTRACT Current insights in the pathogenesis of multiple organ dysfunction in patients with sepsis point to a pivotal role of inflammation and coagulation. One of the most important mechanisms contributing to the activation of coagulation in sepsis is the downregulation of physiologic anticoagulant systems, such as the antithrombin pathway. More than 20 years ago, Eberhard Mammen already hypothesized that coagulation activation and antithrombin were important factors in patients with sepsis. Abundant experimental and clinical studies have supported that notion in recent years. The better understanding of the pathogenesis of coagulation activation and the role of natural anticoagulants in sepsis has led to the development of anticoagulant factor concentrates, such as antithrombin concentrate. Clinical studies indicate that these interventions may have a role in the (supportive) treatment of patients with sepsis, mostly based on surrogate outcomes, but ongoing studies will have to confirm a beneficial effect in reducing mortality.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
ObjectType-Review-3
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ISSN:0094-6176
1098-9064
1098-9064
DOI:10.1055/s-0029-1145256