scholarly journals The prognostic value of ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 repeats, member 13) deficiency in septic shock patients involves interleukin-6 and is not dependent on disseminated intravascular coagulation

Critical Care ◽  
2013 ◽  
Vol 17 (6) ◽  
pp. R273 ◽  
Author(s):  
Vincent Peigne ◽  
Elie Azoulay ◽  
Isaline Coquet ◽  
Eric Mariotte ◽  
Michael Darmon ◽  
...  
Keyword(s):  
Septic Shock ◽  
Disseminated Intravascular Coagulation ◽  
Interleukin 6 ◽  
Prognostic Value ◽  
Intravascular Coagulation ◽  
Thrombospondin Type 1 Repeats

scholarly journals Predictors of Disseminated Intravascular Coagulation in Patients with Septic Shock

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Diana J. Kelm ◽  
Juan Carlos Valerio-Rojas ◽  
Javier Cabello-Garza ◽  
Ognjen Gajic ◽  
Rodrigo Cartin-Ceba
Keyword(s):  
Septic Shock ◽  
Antiplatelet Therapy ◽  
Disseminated Intravascular Coagulation ◽  
Tertiary Care ◽  
Multivariate Logistic Regression Model ◽  
Care Hospital ◽  
Clinical Predictors ◽  
Intravascular Coagulation ◽  
Early Goal Directed Therapy ◽  
Increased Risk

Purpose. The goal of this study was to identify potential clinical predictors for the development of disseminated intravascular coagulation (DIC) in patients with septic shock. Material and Methods. We performed a retrospective analysis of a cohort of adult (>18 years of age) patients with septic shock admitted to a medical ICU in a tertiary care hospital from July 2005 until September 2007. A multivariate logistic regression model was used to determine the association of risk factors with overt DIC. Results. In this study, a total of 390 patients with septic shock were analyzed, of whom 66 (17%) developed overt DIC. Hospital mortality was significantly greater in patients who developed overt DIC (68% versus 38%, P<0.001). A delay in the timing of antibiotics was associated with an increased risk of the development of overt DIC (P<0.001). Patients on antiplatelet therapy prior to hospital admission and who that received adequate early goal-directed therapy (EGDT) were associated with a decreased risk of overt DIC (P<0.001). Conclusions. In our cohort of patients with septic shock, there was a risk reduction for overt DIC in patients on antiplatelet therapy and adequate EGDT, while there was an increased risk of DIC with antibiotic delay.

Serum procalcitonin levels predict disseminated intravascular coagulation in patients with sepsis shock: A retrospective cohort study

2020 ◽  
Author(s):  
Guang Fu ◽  
Xi-si He ◽  
Hao-li Li ◽  
Hai-chao Zhan ◽  
Jun-fu Lu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Cohort Study ◽  
Disseminated Intravascular Coagulation ◽  
Area Under The Curve ◽  
Multivariable Logistic Regression Model ◽  
Intravascular Coagulation ◽  
The Relationship ◽  
Conventional Risk Factors

Abstract Background Complication of disseminated intravascular coagulation (DIC) is a determinant of the prognosis in patients with sepsis shock. Procalcitonin (PCT) has been advocated as a marker of bacterial sepsis. The purpose of this study was to evaluate the relationship between serum PCT levels and DIC with sepsis shock Methods A cohort study was designed which included patients that admitted in intensive care unit (ICU) between January 1, 2015 and December 31, 2018 and the follow-up to discharge. 164 septic shock patients were divided into DIC and non-DIC groups according to international society of thrombosis and homeostasis (ISTH). PCT was measured at the admission to ICU, and all the participants received routine biochemical coagulation test subsequently. Results PCT levels were considerably higher in septic shock patients who developed DIC than those who did not (54.6[13.6–200]vs12.6[2.4–53.3]ng/ml), respectively, P < 0.001). Multivariable logistic regression model revealed that PCT level was significantly associated with risk of DIC independent of conventional risk factors. In addition, curve fitting showed a linear relationship between PCT and DIC score. The Receiver Operating characteristic(ROC) curve suggested that the optimal cut-off point for PCT to predicting DIC induced by septic shock was 42.0 ng/ml, and the area under the curve (AUC) was 0.701(95% CI [0.619–0.784], P < 0.001). More importantly, incorporating PCT with other risk factors into the prediction model significantly increased the AUC for prediction of DIC induced by sepsis shock (0.801vs 0.706; P = 0.012). Conclusions Our study suggests that PCT levels on admission is significantly and independently associated with DIC development subsequently with septic shock, combining PCT levels with other risk factors could significantly improve the prediction of DIC induced by sepsis shock.

Septic Shock, Multiple Organ Failure, and Disseminated Intravascular Coagulation

CHEST Journal ◽  
1992 ◽  
Vol 101 (3) ◽  
pp. 816-823 ◽  
Author(s):  
Francois Fourrier ◽  
Claude Chopin ◽  
Jenny Goudemand ◽  
Sylvie Hendrycx ◽  
Claudine Caron ◽  
...  
Keyword(s):  
Septic Shock ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Disseminated Intravascular Coagulation ◽  
Multiple Organ ◽  
Intravascular Coagulation

Rivaroxaban Has Protective Effects in a Model of Disseminated Intravascular Coagulation (DIC) in Rats.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 935-935 ◽  
Author(s):  
Elisabeth Perzborn ◽  
Claudia Hirth-Dietrich ◽  
Elke Fischer ◽  
Martin Groth ◽  
Elke Hartmann ◽  
...  
Keyword(s):  
Platelet Count ◽  
Disseminated Intravascular Coagulation ◽  
Interleukin 6 ◽  
Factor Xa ◽  
Selective Inhibition ◽  
Vehicle Control ◽  
Protective Effects ◽  
Intravascular Coagulation ◽  
Serious Infection ◽  
Fxa Inhibitor

Abstract Introduction: DIC is a complication that occurs during serious infection with Gram-negative bacteria. Endotoxin is a component of the bacterial cell wall that elicits a cytokine-mediated cascade of tissue factor-dependent hypercoagulable reactions. The resulting hypercoagulable state may be inhibited by potent anticoagulation. Rivaroxaban is an oral, direct Factor Xa (FXa) inhibitor in advanced clinical development for the prevention and treatment of thromboembolic disorders. The aim of this study was to examine the effects of rivaroxaban in a rat model of endotoxin-induced DIC. Methods: Rivaroxaban (0.1–10 mg/kg p.o.) or vehicle control (PEG400/H2O 60/40%, 5 mL/kg p.o.) were administered 30 minutes before endotoxin injection (lipopolysaccharide O55 B5 [LPS], 250 μg/kg i.v.) to conscious rats. Blood samples were withdrawn from anesthetized animals by heart puncture 4 hours after LPS injection and fibrinogen, platelet count, thrombin-antithrombin (TAT) complex levels and IL-6 were measured. Results: The induction of DIC was indicated in the placebo + LPS group vs vehicle control by decreased fibrinogen (2.12±0.08 vs 2.69±0.10 g/L) and platelet count (571±28 vs 904±30×109/L) an increase in TAT (75±9 vs 2±1 μg/L) and IL-6 (8.6±1.23 μg/L vs 0.028±0.020 μg/L). Pretreatment with rivaroxaban (0.1–10 mg/kg p.o.) dose-dependently ameliorated the effects of LPS on fibrinogen, platelets and TAT. Rivaroxaban 10 mg/kg p.o. normalized fibrinogen (2.58±0.07 g/L) and TAT (5.6±1.2 μg/L) and increased platelet count (703±19×109/L) (Table). Rivaroxaban also slightly reduced the plasma levels of the pro-inflammatory cytokine interleukin-6 (IL-6) (4.24±0.67 μg/L). Conclusions: These results show that direct, selective inhibition of FXa by rivaroxaban effectively normalized the hypercoagulable reactions of endotoxemia with a slight modulating effect on the generation of pro-inflammatory active cytokines, such as IL-6, in the rat DIC model. Further research into the use of rivaroxaban in the management of DIC is therefore warranted. Effects of rivaroxaban in an endotoxin-induced DIC model in rats 4 hours after LPS injection. Results show mean ± SEM. Vehicle control Placebo + LPS Rivaroxaban 1 mg/kg + LPS Rivaroxaban 10 mg/kg + LPS DIC, disseminated intravascular coagulation; IL-6, interleukin-6; LPS, lipopolysaccharide O55 B5; SEM, standard error of the mean; TAT, thrombin-antithrombin ## p<0.01 vs sham, ### p<0.001 vs sham, *p<0.05 vs LPS/placebo, ** p<0.01 vs LPS/placebo, *** p<0.001 vs LPS/placebo Fibrinogen (g/L) 2.69±0.10 n=5 2.12±0.08## n=14 2.41±0.09 n=14 2.58± 0.07** n=7 Platelets (×109/l) 904±30 n=5 571±28### n=8 655±23 n=6 703±19* n=7 TAT (μg/L) 1.8±0.8 n=5 75.2±9.4### n=14 65.3±8.0 n=14 5.6±1.2*** n=7 IL-6 (μg/ml) 0.028±0.020 n=5 8.60±1.23### n=6 5.01±0.47 n=6 4.24±0.67 n=7

Disseminated Intravascular Coagulation Following Septic Shock in Multiple Open Fractures : a Case Report

1997 ◽  
Vol 10 (3) ◽  
pp. 583
Author(s):  
Tai Seung Kim ◽  
Jae Lim Cho ◽  
Choong Hyeok Choi ◽  
Sung Hee Oh ◽  
Do Hyeung Kim ◽  
...  
Keyword(s):  
Septic Shock ◽  
Case Report ◽  
Disseminated Intravascular Coagulation ◽  
Open Fractures ◽  
Intravascular Coagulation

Evidence of Netosis in Septic Shock-Induced Disseminated Intravascular Coagulation

Shock ◽  
2017 ◽  
Vol 47 (3) ◽  
pp. 313-317 ◽  
Author(s):  
Xavier Delabranche ◽  
Laure Stiel ◽  
François Severac ◽  
Anne-Cécile Galoisy ◽  
Laurent Mauvieux ◽  
...  
Keyword(s):  
Septic Shock ◽  
Disseminated Intravascular Coagulation ◽  
Intravascular Coagulation
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