Neutrophil Elastase, Thrombin and Plasmin in Septic Shock
In septic shock both bleeding and clotting may occur: a hemorrhagic diathesis due to a lack of coagulation factors as well as disseminated intravascular coagulation (DIC) leading to impaired organ perfusion. Proteolytic systems appear to be involved in both the enhanced turnover of hemostatic proteins and the damage of microcirculation. The classical concept of DIC implicates the action of thrombin and plasmin, the key enzymes of coagulation and fibrinolysis, resprectively. In the past decade evidence has been accumulated1,2 that neutral proteases from neutrophil granulocytes may contribute to the above mentioned complications, and thus influence the prognosis of septic shock. The appearance of active proteases in the plasma is immediately followed by the formation of complexes with their specific inhibitors. Such proteinase-inhibitor complexes (PIC) were determined in 43 patients with septic shock.
KeywordsSeptic Shock Disseminate Intravascular Coagulation Disseminate Intravascular Coagulation Neutrophil Elastase Septic Shock Patient
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