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Coagulation disorders in septic shock

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Abstract

Abnormalities in coagulation and fibrinolysis are frequently observed in septic shock. The most pronounced clinical manifestation is disseminated intravascular coagulation. Recent studies in human volunteers and animal models have clarified the early dynamics and route of activation of both coagulation and fibrinolytic pathways. In healthy subjects subjected to a low dose of either endotoxin or TNF an imbalance in the procoagulant and the fibrinolytic mechanisms is apparent, resulting in a procoagulant state. Also in patients with septic shock a dynamic process of coagulation and fibrinolysis is ongoing with evidence of impaired fibrinolysis. These abnormalities have prognostic significance; the extent of disturbances of coagulation and fibrinolysis is related to the development of multiple organ failure and death.

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Authors and Affiliations

  1. Medical Intensive Care Unit, Free University Hospital, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands

    L. G. Thijs & M. C. M. de Groot

  2. Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, and Laboratory for Experimental and Clinical Immunology, University of Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands

    J. P. de Boer & C. E. Hack

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  1. L. G. Thijs
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  2. J. P. de Boer
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  3. M. C. M. de Groot
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  4. C. E. Hack
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Thijs, L.G., de Boer, J.P., de Groot, M.C.M. et al. Coagulation disorders in septic shock. Intensive Care Med 19 (Suppl 1), S8–S15 (1993). https://doi.org/10.1007/BF01738944

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