Coagulation system and platelets are fully activated in uncomplicated sepsis

Area of Science:

• Hematology
• Critical Care Medicine
• Infectious Diseases

Background:

• Sepsis involves complex interactions between infection and the host's inflammatory and coagulation responses.
• Early activation of coagulation and platelets is a hallmark of sepsis, potentially contributing to organ dysfunction.

Purpose of the Study:

• To investigate the activation of the coagulation system and platelets in the early stage of sepsis.
• To compare these findings with those observed in severe sepsis and septic shock.

Main Methods:

• Prospective study involving 74 septic patients (sepsis, severe sepsis, septic shock) and 14 healthy volunteers.
• Measurement of molecular activation markers of coagulation and platelets, coagulation factors, global coagulation tests, and platelet count.
• Analysis conducted in a general intensive care unit of a tertiary university hospital.

Main Results:

• Sepsis demonstrated increased levels of prothrombin fragments, fibrinopeptide A, thrombin-antithrombin complexes, fibrin monomers, and beta-thromboglobulin.
• Coagulation factors, global coagulation tests, and platelet count remained largely unchanged in sepsis, except for decreased factor XII.
• Severe sepsis and septic shock showed decreased coagulation factors, prolonged global coagulation tests, and reduced platelet counts.

Conclusions:

• The coagulation system and platelets are significantly activated during sepsis.
• Severe sepsis and septic shock represent a state of hemostatic exhaustion due to factor depletion.
• The observed coagulation impairments are consistent across different types of infectious microorganisms.