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Thrombomodulin in intensive care patients

J Boldt1, T Wollbrück, S Sonneborn

  • 1Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University, Giessen, Germany.

Intensive Care Medicine
|August 1, 1995
PubMed
Summary

Critically ill patients show elevated thrombomodulin (TM) levels, especially those with sepsis. Higher TM concentrations correlate with increased mortality, suggesting endothelium-associated coagulation is vital for hemostasis.

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Area of Science:

  • Critical Care Medicine
  • Hematology
  • Vascular Biology

Background:

  • Endothelium-related coagulation plays a role in hemostasis.
  • Critically ill patients often experience complex coagulation disturbances.

Purpose of the Study:

  • To investigate endothelial-related coagulation markers in intensive care patients.
  • To assess the role of thrombomodulin (TM), protein C, and protein S in critically ill patients.

Main Methods:

  • Prospective descriptive study of 40 critically ill patients (trauma or postoperative complications).
  • Measured plasma concentrations of TM, protein C, protein S, and thrombin/antithrombin III (TAT).
  • Utilized enzyme-linked immuno-sorbent assays (ELISA) for measurements.

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Main Results:

  • TM plasma concentrations were significantly higher in septic patients compared to non-septic patients.
  • Elevated TM levels were associated with higher mortality rates.
  • Hemofiltered patients exhibited increased TM levels, which rose during the procedure.

Conclusions:

  • Endothelium-associated coagulation is crucial for hemostasis in critically ill patients.
  • Elevated TM levels, likely due to endothelial damage, are common in these patients, particularly with sepsis.
  • The clinical significance of elevated soluble TM requires further investigation.