Clinical Efficacy of Soluble Thrombomodulin, Tissue Plasminogen Activator Inhibitor complex, Thrombin-Antithrombin complex,α2-Plasmininhibitor-Plasmin complex in Pediatric Sepsis

Objective To investigated the clinical efficacy of Soluble thrombomodulin (sTM), tissue plasminogen activator inhibitor complex (t-PAI·C),thrombin-antithrombin complex (TAT),α2-plasmininhibitor-plasmin complex (PIC) in pediatric sepsis and pediatrics sepsis-induced coagulopathy (pSIC). Methods We pr...

Full description

Bibliographic Details
Main Authors: Juanzhen Li, Jingyi Zhou, Hong Ren, Teng Teng, Biru Li, Ying Wang, Long Xiang
Format: Article
Language:English
Published: SAGE Publishing 2022-05-01
Series:Clinical and Applied Thrombosis/Hemostasis
Online Access:https://doi.org/10.1177/10760296221102929
_version_ 1811247375414460416
author Juanzhen Li
Jingyi Zhou
Hong Ren
Teng Teng
Biru Li
Ying Wang
Long Xiang
author_facet Juanzhen Li
Jingyi Zhou
Hong Ren
Teng Teng
Biru Li
Ying Wang
Long Xiang
author_sort Juanzhen Li
collection DOAJ
description Objective To investigated the clinical efficacy of Soluble thrombomodulin (sTM), tissue plasminogen activator inhibitor complex (t-PAI·C),thrombin-antithrombin complex (TAT),α2-plasmininhibitor-plasmin complex (PIC) in pediatric sepsis and pediatrics sepsis-induced coagulopathy (pSIC). Methods We prospectively collected patient data with sepsis diagnosed in the PICU of Shanghai Children's Medical Center from June 2019 to June 2021. sTM,t-PAI·C, TAT,PIC and classical coagulation laboratory tests (CCTs) were evaluated on the day of sepsis diagnosis. Results Fifty-nine children were enrolled, There were significant differences in t-PAI·C (P = 0.001), Plt (P < 0.001), PT (P < 0.001), INR (P < 0.001), aPTT (P < 0.001), and TT (P = 0.048) between the pSIC and non-pSIC groups, logistic regression analysis showed that Plt (P = 0.032) was an independent risk factor for pSIC. Logistic regression analysis showed that sTM (P = 0.007) and Plt (P = 0.016) were independent risk factors for the outcome in pediatrics sepsis following discharge. The AUC of sTM combined with Plt on the mortality outcome of children with sepsis at discharge was 0.889 (95%CI: 0.781,0.956). which was better than that for PRISM III (AUC, 0.723), pSOFA (AUC, 0.764), and blood Lac (AUC, 0.717) when sepsis was diagnosed in the PICU. Conclusions The t-PAI·C increased in children with pSIC. The prediction of sepsis outcome using sTM combined with Plt was better than with PRISM III, pSOFA, or Lac.Further research is still needed in the future to explore the clinical value of sTM, TAT, PIC, and t-PAI·C in diagnosis and outcome of pediatrics sepsis and pSIC.
first_indexed 2024-04-12T15:08:35Z
format Article
id doaj.art-6cbf8032eb8b49bfa929860e60408141
institution Directory Open Access Journal
issn 1938-2723
language English
last_indexed 2024-04-12T15:08:35Z
publishDate 2022-05-01
publisher SAGE Publishing
record_format Article
series Clinical and Applied Thrombosis/Hemostasis
spelling doaj.art-6cbf8032eb8b49bfa929860e604081412022-12-22T03:27:51ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232022-05-012810.1177/10760296221102929Clinical Efficacy of Soluble Thrombomodulin, Tissue Plasminogen Activator Inhibitor complex, Thrombin-Antithrombin complex,α2-Plasmininhibitor-Plasmin complex in Pediatric SepsisJuanzhen Li0Jingyi Zhou1Hong Ren2Teng Teng3Biru Li4Ying Wang5Long Xiang6 Department of Critical Care Medicine, , Shanghai Jiao Tong University, Shanghai, China Ren Ji Hostipal, Shanghai Jiao Tong University School of Medicine, Shanghai,China Department of Critical Care Medicine, , Shanghai Jiao Tong University, Shanghai, China Department of Critical Care Medicine, , Shanghai Jiao Tong University, Shanghai, China Department of Critical Care Medicine, , Shanghai Jiao Tong University, Shanghai, China Department of Critical Care Medicine, , Shanghai Jiao Tong University, Shanghai, China Department of Neonatal, Second People’s Hospital of Kashgar, Xinjiang Uygur Autonomous Region, ChinaObjective To investigated the clinical efficacy of Soluble thrombomodulin (sTM), tissue plasminogen activator inhibitor complex (t-PAI·C),thrombin-antithrombin complex (TAT),α2-plasmininhibitor-plasmin complex (PIC) in pediatric sepsis and pediatrics sepsis-induced coagulopathy (pSIC). Methods We prospectively collected patient data with sepsis diagnosed in the PICU of Shanghai Children's Medical Center from June 2019 to June 2021. sTM,t-PAI·C, TAT,PIC and classical coagulation laboratory tests (CCTs) were evaluated on the day of sepsis diagnosis. Results Fifty-nine children were enrolled, There were significant differences in t-PAI·C (P = 0.001), Plt (P < 0.001), PT (P < 0.001), INR (P < 0.001), aPTT (P < 0.001), and TT (P = 0.048) between the pSIC and non-pSIC groups, logistic regression analysis showed that Plt (P = 0.032) was an independent risk factor for pSIC. Logistic regression analysis showed that sTM (P = 0.007) and Plt (P = 0.016) were independent risk factors for the outcome in pediatrics sepsis following discharge. The AUC of sTM combined with Plt on the mortality outcome of children with sepsis at discharge was 0.889 (95%CI: 0.781,0.956). which was better than that for PRISM III (AUC, 0.723), pSOFA (AUC, 0.764), and blood Lac (AUC, 0.717) when sepsis was diagnosed in the PICU. Conclusions The t-PAI·C increased in children with pSIC. The prediction of sepsis outcome using sTM combined with Plt was better than with PRISM III, pSOFA, or Lac.Further research is still needed in the future to explore the clinical value of sTM, TAT, PIC, and t-PAI·C in diagnosis and outcome of pediatrics sepsis and pSIC.https://doi.org/10.1177/10760296221102929
spellingShingle Juanzhen Li
Jingyi Zhou
Hong Ren
Teng Teng
Biru Li
Ying Wang
Long Xiang
Clinical Efficacy of Soluble Thrombomodulin, Tissue Plasminogen Activator Inhibitor complex, Thrombin-Antithrombin complex,α2-Plasmininhibitor-Plasmin complex in Pediatric Sepsis
Clinical and Applied Thrombosis/Hemostasis
title Clinical Efficacy of Soluble Thrombomodulin, Tissue Plasminogen Activator Inhibitor complex, Thrombin-Antithrombin complex,α2-Plasmininhibitor-Plasmin complex in Pediatric Sepsis
title_full Clinical Efficacy of Soluble Thrombomodulin, Tissue Plasminogen Activator Inhibitor complex, Thrombin-Antithrombin complex,α2-Plasmininhibitor-Plasmin complex in Pediatric Sepsis
title_fullStr Clinical Efficacy of Soluble Thrombomodulin, Tissue Plasminogen Activator Inhibitor complex, Thrombin-Antithrombin complex,α2-Plasmininhibitor-Plasmin complex in Pediatric Sepsis
title_full_unstemmed Clinical Efficacy of Soluble Thrombomodulin, Tissue Plasminogen Activator Inhibitor complex, Thrombin-Antithrombin complex,α2-Plasmininhibitor-Plasmin complex in Pediatric Sepsis
title_short Clinical Efficacy of Soluble Thrombomodulin, Tissue Plasminogen Activator Inhibitor complex, Thrombin-Antithrombin complex,α2-Plasmininhibitor-Plasmin complex in Pediatric Sepsis
title_sort clinical efficacy of soluble thrombomodulin tissue plasminogen activator inhibitor complex thrombin antithrombin complex α2 plasmininhibitor plasmin complex in pediatric sepsis
url https://doi.org/10.1177/10760296221102929
work_keys_str_mv AT juanzhenli clinicalefficacyofsolublethrombomodulintissueplasminogenactivatorinhibitorcomplexthrombinantithrombincomplexa2plasmininhibitorplasmincomplexinpediatricsepsis
AT jingyizhou clinicalefficacyofsolublethrombomodulintissueplasminogenactivatorinhibitorcomplexthrombinantithrombincomplexa2plasmininhibitorplasmincomplexinpediatricsepsis
AT hongren clinicalefficacyofsolublethrombomodulintissueplasminogenactivatorinhibitorcomplexthrombinantithrombincomplexa2plasmininhibitorplasmincomplexinpediatricsepsis
AT tengteng clinicalefficacyofsolublethrombomodulintissueplasminogenactivatorinhibitorcomplexthrombinantithrombincomplexa2plasmininhibitorplasmincomplexinpediatricsepsis
AT biruli clinicalefficacyofsolublethrombomodulintissueplasminogenactivatorinhibitorcomplexthrombinantithrombincomplexa2plasmininhibitorplasmincomplexinpediatricsepsis
AT yingwang clinicalefficacyofsolublethrombomodulintissueplasminogenactivatorinhibitorcomplexthrombinantithrombincomplexa2plasmininhibitorplasmincomplexinpediatricsepsis
AT longxiang clinicalefficacyofsolublethrombomodulintissueplasminogenactivatorinhibitorcomplexthrombinantithrombincomplexa2plasmininhibitorplasmincomplexinpediatricsepsis