Nevertheless, the importance of coagulation abnormalities should be emphasized in international sepsis guidelines

Area of Science:

• Critical Care Medicine
• Hematology
• Infectious Diseases

Background:

• Coagulation and fibrinolysis disorders are implicated in sepsis pathogenesis.
• Disseminated intravascular coagulation (DIC) is linked to adverse sepsis outcomes.
• The Japanese Surviving Sepsis Campaign guidelines 2020 recommend DIC diagnosis and anticoagulant use in sepsis.

Discussion:

• The International Guidelines for the Management of Sepsis and Septic Shock 2021 do not address coagulation abnormalities or DIC.
• This omission contrasts with recent Japanese recommendations for managing sepsis-associated DIC.
• Evolving sepsis management strategies necessitate re-evaluation of adjunctive treatments.

Key Insights:

• Sepsis-associated disseminated intravascular coagulation (DIC) requires consideration in treatment protocols.
• Anticoagulant therapy is recommended in Japanese sepsis guidelines for DIC.
• A discrepancy exists between Japanese and international sepsis guidelines regarding DIC management.

Outlook:

• Subsequent international guidelines should incorporate the role of anticoagulants for sepsis-associated DIC.
• Further research may clarify the optimal role of anticoagulation in sepsis management.
• Harmonizing global sepsis treatment recommendations is crucial for improved patient outcomes.