Plasma antithrombin III and protein C levels in early recognition of late-onset sepsis in newborns

Lauterbach, Ryszard; Pawlik, Dorota; Radziszewska, Renata; Woźniak, Joanna; Rytlewski, Krzysztof

doi:10.1007/s00431-006-0139-7

Cited by 33 publications

(25 citation statements)

References 10 publications

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“…Recently published studies established low plasma PC activity levels as an independent risk factor for death in low birthweight neonates (3,4), a fact which was described in adults previously (17). According to this data, the preintervention PC plasma activity in the patients reported here had a risk of dying of approximately 80%; alternatively, the NEOMOD score gives this risk as approximately 70%.…”

Section: Patient Characteristicsmentioning

confidence: 71%

Protein C concentrate in preterm neonates with sepsis

et al. 2009

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Section: Patient Characteristicsmentioning

confidence: 71%

Protein C concentrate in preterm neonates with sepsis

et al. 2009

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“…Several studies have reported that plasma levels of antithrombin and protein C are significantly lower in patients with poor prognosis [3-5]. However, these results were based on a relatively small number of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, antithrombin and protein C deficiency are common in DIC patients with poor prognosis [4, 5]. Therefore, plasma levels of natural anticoagulants can be used in the diagnosis and prognosis of DIC.…”

Section: Introductionmentioning

confidence: 99%

Changes in Plasma Levels of Natural Anticoagulants in Disseminated Intravascular Coagulation: High Prognostic Value of Antithrombin and Protein C in Patients with Underlying Sepsis or Severe Infection

et al. 2014

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BackgroundDysfunctional natural anticoagulant systems enhance intravascular fibrin for mation in disseminated intravascular coagulation (DIC), and plasma levels of natural anti coagulants can be used in the diagnosis and prognosis of DIC. Herein, the diagnostic value of 4 natural anticoagulants was assessed, and the prognostic value of antithrombin and protein C were validated in a large population.MethodsPart 1 study included 126 patients with clinically suspected DIC and estimated plasma levels of 4 candidate anticoagulant proteins: antithrombin, protein C, protein S, and protein Z. Part 2 comprised 1,846 patients, in whom plasma antithrombin and protein C levels were compared with other well-known DIC markers according to the underlying dis eases. The 28-day mortality rate was used to assess prognostic outcome.ResultsAntithrombin and protein C showed higher areas under the ROC curve than pro tein S and protein Z. In part 2 of the study, antithrombin and protein C levels significantly correlated with DIC score, suggesting that these factors are good indicators of DIC severity. Antithrombin and protein C showed significant prognostic power in Kaplan-Meier analyses. In patients with sepsis/severe infection, antithrombin and protein C showed higher hazard ratios than D-dimer. Platelet count showed the highest hazard ratio in patients with hemato logic malignancy. In patients with liver disease, the hazard ratio for antithrombin levels was significantly high.ConclusionsDecreased plasma anticoagulant levels reflect florid consumption of the phys iologic defense system against DIC-induced hypercoagulation. Plasma antithrombin and protein C levels are powerful prognostic markers of DIC, especially in patients with sepsis/severe infection.

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“…There is also a shift towards inactivation of protein S and depletion of anticoagulant proteins including antithrombin III (ATIII) and protein C167, 168. A small study demonstrated low protein C levels in preterm neonates with sepsis predicted death169.…”

Section: Pathophysiology Of Sepsis and Shock:molecular And Cellular Ementioning

confidence: 99%

Pathophysiology and Treatment of Septic Shock in Neonates

Wynn

Wong

2010

Clinics in Perinatology

203

153

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Neonatal septic shock is a devastating condition associated with high morbidity and mortality. Definitions for the sepsis continuum and treatment algorithms specific for premature neonates are needed to improve studies of septic shock and assess benefit from clinical interventions. Unique features of the immature immune system and pathophysiologic responses to sepsis, particularly those of extremely preterm infants, necessitate that clinical trials consider them as a separate group. Keen clinical suspicion and knowledge of risk factors will help to identify those neonates at greatest risk for development of septic shock. Genomic and proteomic approaches, particularly those that use very small sample volumes, will increase our understanding of the pathophysiology and direct the development of novel agents for prevention and treatment of severe sepsis and shock in the neonate. Although at present antimicrobial therapy and supportive care remain the foundation of treatment, in the future immunomodulatory agents are likely to improve outcomes for this vulnerable population.

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Plasma antithrombin III and protein C levels in early recognition of late-onset sepsis in newborns

Abstract: We concluded that the measurement of plasma ATIII and, especially, PC levels may facilitate the recognition of sepsis and, with respect to PC, may have a prognostic value. Plasma PC functional concentration below 10% might be the indication for supplementation of PC concentrate.

Cited by 33 publications

References 10 publications

Protein C concentrate in preterm neonates with sepsis

Protein C concentrate in preterm neonates with sepsis

Changes in Plasma Levels of Natural Anticoagulants in Disseminated Intravascular Coagulation: High Prognostic Value of Antithrombin and Protein C in Patients with Underlying Sepsis or Severe Infection

Pathophysiology and Treatment of Septic Shock in Neonates

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