Sepsis-Induced Coagulopathy: A Comprehensive Narrative Review of Pathophysiology, Clinical Presentation, Diagnosis, and Management Strategies.
Journal
Anesthesia and analgesia
ISSN: 1526-7598
Titre abrégé: Anesth Analg
Pays: United States
ID NLM: 1310650
Informations de publication
Date de publication:
01 Apr 2024
01 Apr 2024
Historique:
medline:
18
3
2024
pubmed:
7
2
2024
entrez:
7
2
2024
Statut:
ppublish
Résumé
Physiological hemostasis is a balance between pro- and anticoagulant pathways, and in sepsis, this equilibrium is disturbed, resulting in systemic thrombin generation, impaired anticoagulant activity, and suppression of fibrinolysis, a condition termed sepsis-induced coagulopathy (SIC). SIC is a common complication, being present in 24% of patients with sepsis and 66% of patients with septic shock, and is often associated with poor clinical outcomes and high mortality. 1 , 2 Recent preclinical and clinical studies have generated new insights into the molecular pathogenesis of SIC. In this article, we analyze the complex pathophysiology of SIC with a focus on the role of procoagulant innate immune signaling in hemostatic activation--tissue factor production, thrombin generation, endotheliopathy, and impaired antithrombotic functions. We also review clinical presentations of SIC, the diagnostic scoring system and laboratory tests, the current standard of care, and clinical trials evaluating the efficacies of anticoagulant therapies.
Identifiants
pubmed: 38324297
doi: 10.1213/ANE.0000000000006888
pii: 00000539-990000000-00736
pmc: PMC10916756
doi:
Substances chimiques
Thrombin
EC 3.4.21.5
Anticoagulants
0
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
696-711Subventions
Organisme : NHLBI NIH HHS
ID : K08 HL153784
Pays : United States
Organisme : NIGMS NIH HHS
ID : R35 GM124775
Pays : United States
Organisme : NIGMS NIH HHS
ID : R35 GM140822
Pays : United States
Informations de copyright
Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Anesthesia Research Society.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
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