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Review

The Coagulopathy in Sepsis: Significance and Implications for Treatment

by
Paola Saracco
1,*,
Pasquale Vitale
2,
Carlo Scolfaro
3,
Berardino Pollio
4,
Mauro Pagliarino
5 and
Fabio Timeus
6
1
Hematology Unit, Department of Pediatrics, University of Turin
2
Pediatric Intensive Care Unit, Emergency Department, Regina Margherita S.Anna Hospital
3
Infective Disease Unit, Department of Pediatrics, University of Turin
4
Immunohematology and Transfusion Medicine Unit, Department of Laboratory diagnostic Services, Regina Margherita S. Anna Hospital
5
Immunohematology and Transfusion Medicine Unit, Department of Laboratory diagnostic Services, Regina Margherita S. Anna Hospital
6
Oncohematology and Stem Cell Transplant Unit, Department of Oncology, Regina Margherita S. Anna Hospital, Turin, Italy
*
Author to whom correspondence should be addressed.
Pediatr. Rep. 2011, 3(4), e30; https://doi.org/10.4081/pr.2011.e30
Submission received: 6 October 2011 / Revised: 6 October 2011 / Accepted: 26 October 2011 / Published: 12 December 2011

Abstract

Sepsis related coagulopathy ranges from mild laboratory alterations up to severe disseminated intravascular coagulation (DIC). There is evidence that DIC is involved in the pathogenesis of microvascular dysfunction contributing to organ failure. Additionally, the systemic activation of coagulation, by consuming platelets and coagulation factors, may cause bleeding. Thrombin generation via the tissue factor/factor VIIa route, contemporary depression of antithrombin and protein C anticoagulant system, as well as impaired fibrin degradation, due to high circulating levels of PAI-1, contribute to enhanced intravascular fibrin deposition. This deranged coagulopathy is an independent predictor of clinical outcome in patients with severe sepsis. Innovative supportive strategies aiming at the inhibition of coagulation activation comprise inhibition of tissue factor-mediated activation or restoration of physiological anticoagulant pathways, as the administration of recombinant human activated protein C or concentrate. In spite of some promising initial studies, additional trials are needed to define their clinical effectiveness in adults and children with severe sepsis.
Keywords: sepsis; disseminated activated coagulation; coagulopathy; treatment sepsis; disseminated activated coagulation; coagulopathy; treatment

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MDPI and ACS Style

Saracco, P.; Vitale, P.; Scolfaro, C.; Pollio, B.; Pagliarino, M.; Timeus, F. The Coagulopathy in Sepsis: Significance and Implications for Treatment. Pediatr. Rep. 2011, 3, e30. https://doi.org/10.4081/pr.2011.e30

AMA Style

Saracco P, Vitale P, Scolfaro C, Pollio B, Pagliarino M, Timeus F. The Coagulopathy in Sepsis: Significance and Implications for Treatment. Pediatric Reports. 2011; 3(4):e30. https://doi.org/10.4081/pr.2011.e30

Chicago/Turabian Style

Saracco, Paola, Pasquale Vitale, Carlo Scolfaro, Berardino Pollio, Mauro Pagliarino, and Fabio Timeus. 2011. "The Coagulopathy in Sepsis: Significance and Implications for Treatment" Pediatric Reports 3, no. 4: e30. https://doi.org/10.4081/pr.2011.e30

APA Style

Saracco, P., Vitale, P., Scolfaro, C., Pollio, B., Pagliarino, M., & Timeus, F. (2011). The Coagulopathy in Sepsis: Significance and Implications for Treatment. Pediatric Reports, 3(4), e30. https://doi.org/10.4081/pr.2011.e30

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