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Phenotype-oriented anticoagulant therapy for sepsis: still a work in progress

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Abstract

Coagulation disorders ranging from subtle changes in coagulation parameters to fatal disseminated intravascular coagulation (DIC) are common in septic patients. Coagulation activation is considered to be one of the most important factors contributing to multiple organ dysfunction syndrome (MODS) in sepsis. Anticoagulant therapy is, therefore, necessary to prevent MODS, but eligibility criteria remain controversial. Sepsis is a highly heterogeneous syndrome, which could explain the negative results of clinical studies on the treatment of sepsis. Recently, sepsis has been subdivided into several phenotypes with different therapeutic outcomes. At present, septic patients with dysfunctional coagulation expressed as increased D-dimer and fibrin/fibrinogen degradation products (FDPs) are considered to be candidates for anticoagulant therapy. In this review, we aimed to describe the features of different septic phenotypes. We also discuss factors that contribute to controversies in this area, and challenges in defining which septic phenotypes are good candidates for anticoagulant therapy.

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Acknowledgement

We acknowledge all staff who helped perform this study. The present review was supported by the National Natural Science Foundation of China (81671936).

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Authors and Affiliations

  1. Department of Critical Care Medicine, The First Affiliated Hospital of China Medical University, North Nanjing Street 155, Shenyang, 110000, Liaoning Province, China

    Sihan Yu, Xiaochun Ma & Xu Li

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  1. Sihan Yu
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  2. Xiaochun Ma
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  3. Xu Li
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Contributions

All authors had their substantial contributions to the conception or design of the work or the acquisition and interpretation of data. SHY drafted the initial manuscript; XL and XCM revised it critically for important intellectual content. All authors read and approved the final manuscript.

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Correspondence to Xu Li.

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Yu, S., Ma, X. & Li, X. Phenotype-oriented anticoagulant therapy for sepsis: still a work in progress. Int J Hematol 116, 48–54 (2022). https://doi.org/10.1007/s12185-022-03337-5

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