Document Detail


Coagulation dysfunction in sepsis and multiple organ system failure.
MedLine Citation:
PMID:  12848314     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In patients diagnosed with sepsis, severe sepsis or septic shock, cytokine-mediated endothelial injury, and TF activation initiate a cascade of events that culminate in the development of coagulation dysfunction characterized as procoagulant and antifibrinolytic. This abnormal state predisposes the patient to develop microvascular thrombosis, tissue ischemia, and organ hypoperfusion. Multiple organ dysfunction syndrome may be a product of this pertubation in coagulation regulation. Treatments aimed at correcting this coagulation dysfunction have met with mixed success. Current data suggest that AT III replacement therapy has limited efficacy in adults with severe sepsis. In contrast, adult patients diagnosed with severe sepsis and organ failure and treated with aPC (drotrecogin alfa activate) have a significantly reduced risk of death when compared with placebo-treated patients. A phase III trial examining the efficacy of protein C replacement therapy in pediatric patients with severe sepsis and organ failure is underway.
Authors:
Marianne Nimah; Richard J Brilli
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Critical care clinics     Volume:  19     ISSN:  0749-0704     ISO Abbreviation:  Crit Care Clin     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-09     Completed Date:  2003-08-05     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8507720     Medline TA:  Crit Care Clin     Country:  United States    
Other Details:
Languages:  eng     Pagination:  441-58     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
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MeSH Terms
Descriptor/Qualifier:
Antithrombin III / therapeutic use
Blood Coagulation Disorders / drug therapy,  etiology*,  physiopathology
Humans
Lipoproteins / therapeutic use
Multiple Organ Failure / complications*,  physiopathology
Pediatrics
Protein C / therapeutic use
Recombinant Proteins / therapeutic use
Shock, Septic / complications*,  physiopathology
Chemical
Reg. No./Substance:
0/Lipoproteins; 0/Protein C; 0/Recombinant Proteins; 0/lipoprotein-associated coagulation inhibitor; 9000-94-6/Antithrombin III

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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