Sepsis-Induced Coagulopathy: An Update on Pathophysiology, Biomarkers, and Current Guidelines
Significant cross talk occurs between inflammation and coagulation. Thus, coagulopathy is common in sepsis, potentially aggravating the prognosis. Initially, septic patients tend to exhibit a prothrombotic state through extrinsic pathway activation, cytokine-induced coagulation amplification, antico...
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MDPI AG
2023-01-01
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| Series: | Life |
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| Online Access: | https://www.mdpi.com/2075-1729/13/2/350 |
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| author | Andreas G. Tsantes Stavroula Parastatidou Emmanuel A. Tsantes Elli Bonova Konstantina A. Tsante Petros G. Mantzios Aristeidis G. Vaiopoulos Stavros Tsalas Aikaterini Konstantinidi Dimitra Houhoula Nicoletta Iacovidou Daniele Piovani Georgios K. Nikolopoulos Rozeta Sokou |
| author_facet | Andreas G. Tsantes Stavroula Parastatidou Emmanuel A. Tsantes Elli Bonova Konstantina A. Tsante Petros G. Mantzios Aristeidis G. Vaiopoulos Stavros Tsalas Aikaterini Konstantinidi Dimitra Houhoula Nicoletta Iacovidou Daniele Piovani Georgios K. Nikolopoulos Rozeta Sokou |
| author_sort | Andreas G. Tsantes |
| collection | DOAJ |
| description | Significant cross talk occurs between inflammation and coagulation. Thus, coagulopathy is common in sepsis, potentially aggravating the prognosis. Initially, septic patients tend to exhibit a prothrombotic state through extrinsic pathway activation, cytokine-induced coagulation amplification, anticoagulant pathways suppression, and fibrinolysis impairment. In late sepsis stages, with the establishment of disseminated intravascular coagulation (DIC), hypocoagulability ensues. Traditional laboratory findings of sepsis, including thrombocytopenia, increased prothrombin time (PT) and fibrin degradation products (FDPs), and decreased fibrinogen, only present late in the course of sepsis. A recently introduced definition of sepsis-induced coagulopathy (SIC) aims to identify patients at an earlier stage when changes to coagulation status are still reversible. Nonconventional assays, such as the measurement of anticoagulant proteins and nuclear material levels, and viscoelastic studies, have shown promising sensitivity and specificity in detecting patients at risk for DIC, allowing for timely therapeutic interventions. This review outlines current insights into the pathophysiological mechanisms and diagnostic options of SIC. |
| first_indexed | 2024-03-11T08:32:29Z |
| format | Article |
| id | doaj.art-6e5b949150a54711b8a2160c2b6592ca |
| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-11T08:32:29Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-6e5b949150a54711b8a2160c2b6592ca2023-11-16T21:40:02ZengMDPI AGLife2075-17292023-01-0113235010.3390/life13020350Sepsis-Induced Coagulopathy: An Update on Pathophysiology, Biomarkers, and Current GuidelinesAndreas G. Tsantes0Stavroula Parastatidou1Emmanuel A. Tsantes2Elli Bonova3Konstantina A. Tsante4Petros G. Mantzios5Aristeidis G. Vaiopoulos6Stavros Tsalas7Aikaterini Konstantinidi8Dimitra Houhoula9Nicoletta Iacovidou10Daniele Piovani11Georgios K. Nikolopoulos12Rozeta Sokou13Laboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, GreeceNeonatal Intensive Care Unit, 3rd Department of Paediatrics, “Attiko” Hospital, 12462 Athens, GreeceLaboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, GreeceDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, ItalyLaboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, GreeceLaboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, GreeceLaboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, GreeceLaboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, GreeceNeonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 18454 Piraeus, GreeceLaboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, GreeceNeonatal Department, National and Kapodistrian University of Athens, Aretaeio Hospital, 11528 Athens, GreeceDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, ItalyMedical School, University of Cyprus, Nicosia 2029, CyprusNeonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 18454 Piraeus, GreeceSignificant cross talk occurs between inflammation and coagulation. Thus, coagulopathy is common in sepsis, potentially aggravating the prognosis. Initially, septic patients tend to exhibit a prothrombotic state through extrinsic pathway activation, cytokine-induced coagulation amplification, anticoagulant pathways suppression, and fibrinolysis impairment. In late sepsis stages, with the establishment of disseminated intravascular coagulation (DIC), hypocoagulability ensues. Traditional laboratory findings of sepsis, including thrombocytopenia, increased prothrombin time (PT) and fibrin degradation products (FDPs), and decreased fibrinogen, only present late in the course of sepsis. A recently introduced definition of sepsis-induced coagulopathy (SIC) aims to identify patients at an earlier stage when changes to coagulation status are still reversible. Nonconventional assays, such as the measurement of anticoagulant proteins and nuclear material levels, and viscoelastic studies, have shown promising sensitivity and specificity in detecting patients at risk for DIC, allowing for timely therapeutic interventions. This review outlines current insights into the pathophysiological mechanisms and diagnostic options of SIC.https://www.mdpi.com/2075-1729/13/2/350sepsiscoagulationdisseminated intravascular coagulationsepsis-induced coagulopathylaboratory evaluationguidelines |
| spellingShingle | Andreas G. Tsantes Stavroula Parastatidou Emmanuel A. Tsantes Elli Bonova Konstantina A. Tsante Petros G. Mantzios Aristeidis G. Vaiopoulos Stavros Tsalas Aikaterini Konstantinidi Dimitra Houhoula Nicoletta Iacovidou Daniele Piovani Georgios K. Nikolopoulos Rozeta Sokou Sepsis-Induced Coagulopathy: An Update on Pathophysiology, Biomarkers, and Current Guidelines Life sepsis coagulation disseminated intravascular coagulation sepsis-induced coagulopathy laboratory evaluation guidelines |
| title | Sepsis-Induced Coagulopathy: An Update on Pathophysiology, Biomarkers, and Current Guidelines |
| title_full | Sepsis-Induced Coagulopathy: An Update on Pathophysiology, Biomarkers, and Current Guidelines |
| title_fullStr | Sepsis-Induced Coagulopathy: An Update on Pathophysiology, Biomarkers, and Current Guidelines |
| title_full_unstemmed | Sepsis-Induced Coagulopathy: An Update on Pathophysiology, Biomarkers, and Current Guidelines |
| title_short | Sepsis-Induced Coagulopathy: An Update on Pathophysiology, Biomarkers, and Current Guidelines |
| title_sort | sepsis induced coagulopathy an update on pathophysiology biomarkers and current guidelines |
| topic | sepsis coagulation disseminated intravascular coagulation sepsis-induced coagulopathy laboratory evaluation guidelines |
| url | https://www.mdpi.com/2075-1729/13/2/350 |
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