open access

Vol 48, No 5 (2016)
Review articles
Published online: 2016-11-07
Submitted: 2016-09-10
Accepted: 2016-11-02
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Coagulopathy in sepsis — a new look at an old problem

Małgorzata Lipinska-Gediga
DOI: 10.5603/AIT.a2016.0051
·
Pubmed: 27824218
·
Anaesthesiol Intensive Ther 2016;48(5):352-359.

open access

Vol 48, No 5 (2016)
Review articles
Published online: 2016-11-07
Submitted: 2016-09-10
Accepted: 2016-11-02

Abstract

Sepsis is a life-threatening condition characterized by a systemic response to microbial infection. Despite considerable progress in intensive care medicine, the incidence of sepsis and the number of sepsis-related deaths are increasing world-wide. There is a complex relationship between the coagulation, immune and inflammatory systems in sepsis. Activation of the coagulation cascade in sepsis is a result of a pathogen invasion and is a part of a immuno-inflammatory host response. In sepsis, the close cooperation of the immune and coagulation systems through cross signalling results in immunothrombosis. According to a recently described new theory, immunothrombosis is a immune response in which the local activation of coagulation facilitates the recognition and destruction of pathogens. Small amounts of clot formation are beneficial for the host because of bacteria trapping and prevention of the systemic spread of infection. Sepsis is a dynamic syndrome and in all patients with sepsis coagulation changes may progress from a normal profile to hypercoagulability and hypofibrinolysis, hyperfibrinolysis, and ultimately hypocoagulability.

Abstract

Sepsis is a life-threatening condition characterized by a systemic response to microbial infection. Despite considerable progress in intensive care medicine, the incidence of sepsis and the number of sepsis-related deaths are increasing world-wide. There is a complex relationship between the coagulation, immune and inflammatory systems in sepsis. Activation of the coagulation cascade in sepsis is a result of a pathogen invasion and is a part of a immuno-inflammatory host response. In sepsis, the close cooperation of the immune and coagulation systems through cross signalling results in immunothrombosis. According to a recently described new theory, immunothrombosis is a immune response in which the local activation of coagulation facilitates the recognition and destruction of pathogens. Small amounts of clot formation are beneficial for the host because of bacteria trapping and prevention of the systemic spread of infection. Sepsis is a dynamic syndrome and in all patients with sepsis coagulation changes may progress from a normal profile to hypercoagulability and hypofibrinolysis, hyperfibrinolysis, and ultimately hypocoagulability.

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Keywords

sepsis, coagulopathy; immunothrombosis; neutrophil extracellular traps; thrombocytes; fibrinolysis

About this article
Title

Coagulopathy in sepsis — a new look at an old problem

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 48, No 5 (2016)

Pages

352-359

Published online

2016-11-07

DOI

10.5603/AIT.a2016.0051

Pubmed

27824218

Bibliographic record

Anaesthesiol Intensive Ther 2016;48(5):352-359.

Keywords

sepsis
coagulopathy
immunothrombosis
neutrophil extracellular traps
thrombocytes
fibrinolysis

Authors

Małgorzata Lipinska-Gediga

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