Decreased plasma activity of antithrombin or protein C is not due to consumption coagulopathy in septic patients with disseminated intravascular coagulation

Asakura, Hitoshi; Ontachi, Yasuo; Mizutani, Tomoe; Kato, Minori; Ito, Takako; Saitô, Masanori; Morishita, Eriko; Yamazaki, Masahide; Aoshima, Keiji; Takami, Akiyoshi; Yoshida, Tomotaka; Suga, Yukio; Miyamoto, Ken‐ichi; Nakao, Shinji

doi:10.1034/j.1600-0609.2001.5790508.x

Cited by 63 publications

(42 citation statements)

References 25 publications

(36 reference statements)

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“…However, in this study, we found no correlations between TAT and AT activity in the pre-administration phase in critical patients with DIC. Furthermore, TAT is believed to be uncorrelated with AT activity because the total amount of AT in the body is so enormous that AT levels would not decrease even after remarkable TAT production [35]. Therefore, the present results confirm the data of the previous paper [35].…”

Section: Relations Of At Activity and Tat Or Albumin Levelssupporting

confidence: 83%

“…Therefore, it is possible that the serum albumin level could be a reliable index for estimating changes in the post-administration AT levels in critical patients with DIC. Furthermore, this study supports a previous paper [35] that in septic patients with DIC, AT could be decreased by enhanced vascular permeability rather than its consumption. …”

Section: Relations Of At Activity and Tat Or Albumin Levelssupporting

confidence: 80%

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Pharmacokinetic (PK) Characteristics in Critically Ill Patients

Aibiki¹,

Fukuoka²

2015

Basic Pharmacokinetic Concepts and Some Clinical Applications

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Section: Relations Of At Activity and Tat Or Albumin Levelssupporting

confidence: 83%

Section: Relations Of At Activity and Tat Or Albumin Levelssupporting

confidence: 80%

Pharmacokinetic (PK) Characteristics in Critically Ill Patients

Aibiki¹,

Fukuoka²

2015

Basic Pharmacokinetic Concepts and Some Clinical Applications

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“…PT, fibrinogen, platelet count, and fibrin and FDP were measured in each institutes based on numerous previous reports [16][17][18]. An FDP assay in each institute correlated well with LPIA FDP (Mitsubishi Chemical Medience Corporation, Tokyo, Japan).…”

Section: Methodsmentioning

confidence: 99%

Modified non‐overt DIC diagnostic criteria predict the early phase of overt‐DIC

et al. 2010

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of Thrombosis Hemostasis/DIC subcommittee Diagnostic criteria for non-overt disseminated intravascular coagulation (DIC) have been proposed by the International Society of Thrombosis and Hemostasis, but are not useful for the diagnosis of early phase of overt-DIC (pre-DIC). Therefore, in the current study the non-overt DIC diagnostic criteria were modified using the global coagulation tests, the change rate in the global coagulation tests and molecular hemostatic markers to detect the pre-DIC state and were prospectively evaluated in 613 patients with underlying DIC disease. The frequencies of patients with DIC (DIC positive), late onset DIC, and without DIC (DIC absent) were 29.5%, 7.2%, and 63.3%, respectively. The modified non-overt-DIC criteria can correctly predict 43/44 patients (97.7%) who were DIC absent at admission and became DIC positive, within a week (late onset DIC state). The mortality rate was higher in DIC positive compared with pre-DIC (37.6% vs. 22.7%, P < 0.05) or DIC negative (37.6 vs. 13.7%, P < 0.01). It was also significantly higher in pre-DIC compared with DIC negative (P < 0.05). Thus, these modified non-overt DIC diagnostic criteria might therefore be useful for the diagnosis of early-phase DIC. Am. J. Hematol. 85:691-694, 2010. V V C 2010 Wiley-Liss, Inc. IntroductionSeveral diagnostic criteria for disseminated intravascular coagulation (DIC) have been proposed by Colman et al. [1], the Japanese Ministry Health and Welfare (JMHW) [2], and the International Society of Thrombosis and Hemostasis (ISTH) [3], among others. In these diagnostic criteria, global coagulation tests such as the prothrombin time (PT), platelet count, fibrinogen and fibrin and fibrinogen degradation products (FDP) or D-dimer are primarily used for scoring for hemostatic abnormalities. A retrospective study [4] showed that the concordance rate between the JMHW and ISTH diagnostic criteria was 67.4%, and that the ISTH overt-DIC diagnostic criteria were less sensitive for DIC diagnosis than the JMHW criteria. Although the DIC subcommittee of the Scientific Standardized Committee (SSC) in the ISTH emphasized vascular endothelial cell injury as a definition of DIC [3], scoring system based on these three diagnostic criteria do not reflect vascular endothelial cell injury. Recent clinical trials for severe sepsis [5][6][7] showed that the mortality rate of patients with severe sepsis was 35-45% and was even higher in patients with DIC than patients without DIC. The frequency of DIC in patients with severe sepsis was 40.7% according to the KyberSept trial results (antithrombin; AT) [5] and 22.4% in the PROWESS study (recombinant activated protein C; APC) [6]. The patients with severe sepsis have a poor prognosis and the septic patients who also have DIC have an even worse outcome.The treatment efficacy in relation to the JMHW DIC score at the beginning of treatment showed that a greater efficacy was achieved in pre-DIC patients than in DIC patients [8]. The patient prognosis was progressively worse with increasing DIC sc...

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“…The inflammation mediators induced by thrombotization lead to further coagulation activation by suppressing natural coagulation inhibitors -antithrombin, activated protein C and TFPI (ref. 28,29 ). Products of activation of TF -F IIa, F VIIa, Xa -cause further overexpression of tissue factor, which closes the vicious circle: thrombosis-inflammationthrombosis, linked by tissue factor 30,31 .…”

Section: Tissue Factor -Regulation Of Its Expressionmentioning

confidence: 99%

The role of tissue factor in normal pregnancy and in the development of preeclampsia: A review

Procházková¹,

Slavík²,

Úlehlová³

et al. 2015

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background. Tissue factor (TF) is a key element for normal gestation, especially in the first trimester. TF levels are hence raised in pregnancy, producing an adaptive hypercoagulable state. Potentiated hypercoagulability however, is associated with disorders of pregnancy such as pre-eclampsia but the results of TF and its inhibitor, tissue factor pathway inhibitor (TFPI), measurement, in pre eclampsic women are ambiguous and the data conflicting. This review covers the current knowledge status of the role of TF assessment in pregnancy with a focus on its diagnostic utility. Methods. A review of the literature using the following key words: tissue factor, thrombosis, inflammation, pregnancy, preeclampsia.Results. The published literature shows raised and unchanged TF levels in various studies of pre-eclampsia along with equally conflicting data for TFPI. The various study designs and methods used in these studies makes valid comparison difficult. Meta analysis of 34 randomized trials showed that low-dose aspirin in early phases of gravidity (starting from the 16th week or earlier) significantly reduces the incidence of preeclampsia. Conclusions. Overall, the results of the literature search together with knowledge of the structure and biological effects of TF, suggest that measuring the level of plasma TF/TFPI is not ideal for determining the actual levels of TF in the uteroplacental circulation. The current view that endothelial dysfunction is the trigger for preeclampsia, suggests that aspirin may be an effective prophylaxis. Further research will be necessary: measuring the expression of tissue factor on monocytes using flowcytometry and comparing the development of this expression during normal pregnancy and pregnancy complicated by preeclampsia, for example. Another possibility is immunohistochemical determination of the level of TF expression directly in placental tissue.

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Decreased plasma activity of antithrombin or protein C is not due to consumption coagulopathy in septic patients with disseminated intravascular coagulation

Cited by 63 publications

References 25 publications

Pharmacokinetic (PK) Characteristics in Critically Ill Patients

Pharmacokinetic (PK) Characteristics in Critically Ill Patients

Modified non‐overt DIC diagnostic criteria predict the early phase of overt‐DIC

The role of tissue factor in normal pregnancy and in the development of preeclampsia: A review

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