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The coagulopathy in sepsis: significance and implications for treatment

Paola Saracco1, Pasquale Vitale, Carlo Scolfaro

  • 1Hematology Unit, Department of Pediatrics, University of Turin;

Pediatric Reports
|February 23, 2012
PubMed

Insights

Sepsis-associated coagulopathy, including disseminated intravascular coagulation (DIC), impairs microvascular function and predicts outcomes. Strategies targeting coagulation activation or restoring anticoagulation show promise but require further clinical trials.

Area of Science:

  • Coagulation and Thrombosis
  • Critical Care Medicine
  • Sepsis Pathophysiology

Background:

  • Sepsis-induced coagulopathy spans mild alterations to severe disseminated intravascular coagulation (DIC).
  • DIC contributes to microvascular dysfunction and organ failure in sepsis.
  • Coagulation activation consumes platelets and factors, potentially causing bleeding.

Purpose of the Study:

  • To review the role of coagulopathy in sepsis pathogenesis and outcomes.
  • To discuss novel supportive strategies for sepsis-related coagulopathy.
  • To highlight the need for further clinical trials on these strategies.

Main Methods:

  • Literature review of sepsis-associated coagulopathy.
  • Analysis of coagulation pathways involved in sepsis.
  • Discussion of emerging therapeutic interventions.

Main Results:

  • Sepsis-related coagulopathy is an independent predictor of clinical outcome.
  • Enhanced intravascular fibrin deposition results from complex coagulation dysregulation.
  • Potential strategies include inhibiting tissue factor or restoring anticoagulant pathways.

Conclusions:

  • Current evidence suggests DIC is integral to sepsis-induced organ failure.
  • Restoring physiological anticoagulation (e.g., recombinant human activated protein C) warrants investigation.
  • Further clinical trials are essential to establish the efficacy of novel treatments in pediatric and adult sepsis.

Keywords:
coagulopathydisseminated activated coagulationsepsistreatment.

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