Decoding Sepsis-Induced Disseminated Intravascular Coagulation: A Comprehensive Review of Existing and Emerging Therapies
Disseminated intravascular coagulation (DIC) is a recurrent complication of sepsis. Since DIC not only promotes organ dysfunction but also represents a strong prognostic factor, it is important to diagnose DIC as early as possible. When coagulation is activated, fibrinolysis is inhibited, blood thin...
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| Format: | Article |
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MDPI AG
2023-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/19/6128 |
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| author | Ahsanullah Unar Lorenzo Bertolino Fabian Patauner Raffaella Gallo Emanuele Durante-Mangoni |
| author_facet | Ahsanullah Unar Lorenzo Bertolino Fabian Patauner Raffaella Gallo Emanuele Durante-Mangoni |
| author_sort | Ahsanullah Unar |
| collection | DOAJ |
| description | Disseminated intravascular coagulation (DIC) is a recurrent complication of sepsis. Since DIC not only promotes organ dysfunction but also represents a strong prognostic factor, it is important to diagnose DIC as early as possible. When coagulation is activated, fibrinolysis is inhibited, blood thinners are consumed, and a condition is created that promotes blood clotting, making it more difficult for the body to remove fibrin or prevent it from being deposited in the blood vessels. This leads to microvascular thrombosis, which plays a role in organ dysfunction. Despite efforts to understand the underlying mechanisms of sepsis-induced DIC, healthcare providers worldwide still face challenges in effectively treating this condition. In this review, we provide an in-depth analysis of the available strategies for sepsis-induced DIC, considering their effectiveness, limitations, and potential for future advances. Corticosteroids (CS), recombinant thrombomodulin (rTM), vitamin C, fibrinolytic therapy, and platelet transfusion are among the treatments discussed in the review. In addition, we are specifically addressing immunomodulatory therapy (IMT) by investigating treatments such as granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon gamma (IFN-γ), and mesenchymal stem cell therapy (MSC). Finally, we also examined how these therapies might affect COVID-19 cases, which often present with sepsis-induced DIC. The review suggests that targeted experiments with randomization are needed to verify the effectiveness of these treatments and to discover novel approaches to treat sepsis-induced DIC. By increasing our knowledge of sepsis-induced DIC, we can develop targeted treatments that have the potential to save lives and improve outcomes. |
| first_indexed | 2024-03-10T21:42:24Z |
| format | Article |
| id | doaj.art-0f33694cab9c47c2baacabc293544955 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T21:42:24Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-0f33694cab9c47c2baacabc2935449552023-11-19T14:34:28ZengMDPI AGJournal of Clinical Medicine2077-03832023-09-011219612810.3390/jcm12196128Decoding Sepsis-Induced Disseminated Intravascular Coagulation: A Comprehensive Review of Existing and Emerging TherapiesAhsanullah Unar0Lorenzo Bertolino1Fabian Patauner2Raffaella Gallo3Emanuele Durante-Mangoni4Department of Precision Medicine, University of Campania ‘L. Vanvitelli’, 80138 Naples, ItalyDepartment of Precision Medicine, University of Campania ‘L. Vanvitelli’, 80138 Naples, ItalyDepartment of Precision Medicine, University of Campania ‘L. Vanvitelli’, 80138 Naples, ItalyDepartment of Precision Medicine, University of Campania ‘L. Vanvitelli’, 80138 Naples, ItalyDepartment of Precision Medicine, University of Campania ‘L. Vanvitelli’, 80138 Naples, ItalyDisseminated intravascular coagulation (DIC) is a recurrent complication of sepsis. Since DIC not only promotes organ dysfunction but also represents a strong prognostic factor, it is important to diagnose DIC as early as possible. When coagulation is activated, fibrinolysis is inhibited, blood thinners are consumed, and a condition is created that promotes blood clotting, making it more difficult for the body to remove fibrin or prevent it from being deposited in the blood vessels. This leads to microvascular thrombosis, which plays a role in organ dysfunction. Despite efforts to understand the underlying mechanisms of sepsis-induced DIC, healthcare providers worldwide still face challenges in effectively treating this condition. In this review, we provide an in-depth analysis of the available strategies for sepsis-induced DIC, considering their effectiveness, limitations, and potential for future advances. Corticosteroids (CS), recombinant thrombomodulin (rTM), vitamin C, fibrinolytic therapy, and platelet transfusion are among the treatments discussed in the review. In addition, we are specifically addressing immunomodulatory therapy (IMT) by investigating treatments such as granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon gamma (IFN-γ), and mesenchymal stem cell therapy (MSC). Finally, we also examined how these therapies might affect COVID-19 cases, which often present with sepsis-induced DIC. The review suggests that targeted experiments with randomization are needed to verify the effectiveness of these treatments and to discover novel approaches to treat sepsis-induced DIC. By increasing our knowledge of sepsis-induced DIC, we can develop targeted treatments that have the potential to save lives and improve outcomes.https://www.mdpi.com/2077-0383/12/19/6128sepsisdisseminated intravascular coagulationtherapycorticosteroidsrecombinant thrombomodulinvitamin C |
| spellingShingle | Ahsanullah Unar Lorenzo Bertolino Fabian Patauner Raffaella Gallo Emanuele Durante-Mangoni Decoding Sepsis-Induced Disseminated Intravascular Coagulation: A Comprehensive Review of Existing and Emerging Therapies Journal of Clinical Medicine sepsis disseminated intravascular coagulation therapy corticosteroids recombinant thrombomodulin vitamin C |
| title | Decoding Sepsis-Induced Disseminated Intravascular Coagulation: A Comprehensive Review of Existing and Emerging Therapies |
| title_full | Decoding Sepsis-Induced Disseminated Intravascular Coagulation: A Comprehensive Review of Existing and Emerging Therapies |
| title_fullStr | Decoding Sepsis-Induced Disseminated Intravascular Coagulation: A Comprehensive Review of Existing and Emerging Therapies |
| title_full_unstemmed | Decoding Sepsis-Induced Disseminated Intravascular Coagulation: A Comprehensive Review of Existing and Emerging Therapies |
| title_short | Decoding Sepsis-Induced Disseminated Intravascular Coagulation: A Comprehensive Review of Existing and Emerging Therapies |
| title_sort | decoding sepsis induced disseminated intravascular coagulation a comprehensive review of existing and emerging therapies |
| topic | sepsis disseminated intravascular coagulation therapy corticosteroids recombinant thrombomodulin vitamin C |
| url | https://www.mdpi.com/2077-0383/12/19/6128 |
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