Septic Shock, Multiple Organ Failure, and Disseminated Intravascular Coagulation

Fourrier, F.; Chopin, C.; Goudemand, Jenny; Hendrycx, Sylvie; Caron, Claudine; Rime, Alain; Marey, A.; Lestavel, P.

doi:10.1378/chest.101.3.816

Cited by 641 publications

(127 citation statements)

References 24 publications

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“…The normal range of circulating levels of PC has been established by several studies and varies over approximately a two-fold range between the upper and lower limits (70%-140%) (18)(19)(20). Numerous studies have shown that acquired PC deficiency is prevalent in the majority of septic patients and is associated with increased morbidity and mortality (21)(22)(23). In the present study, only PC levels 48 hours after initiation in patients who died were below the lower limit.…”

Section: Discussioncontrasting

confidence: 47%

Several Cytokines and Protein C Levels with the Apache II Scoring System for Evaluation of Patients with Sepsis

Kartal¹,

Karkaç²,

Gülbaş³

et al. 2012

Balkan Med J

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Objective: We investigated whether determination IL-6, IL-8, IL-1beta and TNF-alpha at baseline, total protein C (PC) levels at time of admission and 48 hours after initiation could complement the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system to identify patients with sepsis, severe sepsis or septic shock for clinical outcome. Material and Methods:The study was carried out prospectively. 60 consecutive patients with sepsis, severe sepsis or septic shock were included. Blood samples were obtained at baseline and 48 hours after initiation. Cytokines and PC levels in plasma were measured with an enzyme-linked immunoabsorbent assay (ELISA). APACHE II score was calculated on admission.Results: Baseline IL-6 levels and PC levels 48 hours after initiation were predictive of increased mortality (p=0.016, p=0.044 respectively). Baseline IL-6, IL-8 and TNF-alpha baseline levels correlate with the severity of physiologic insult, as determined by the APACHE II score. However, our multiple logistic regression analysis of these did not reveal any predictive value in combination with the APACHE II score. Conclusion:Determination of baseline IL-6 and PC 48 hours after initiation were of predictive value for prognostic evaluation of septic patients, but did not significantly increase predictive power of the APACHE scoring system to identify patients with sepsis for fatal clinical outcome.

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Section: Discussioncontrasting

confidence: 47%

Several Cytokines and Protein C Levels with the Apache II Scoring System for Evaluation of Patients with Sepsis

Kartal¹,

Karkaç²,

Gülbaş³

et al. 2012

Balkan Med J

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“…The intravascular expression of TF, and the increase in plasma levels of TNF alpha and IL-1, have been implicated in the onset of the multiple organ failure syndrome observed in Gram-negative septic shock [15]. The demonstration that IL-10 is capable of inhibiting the production of both molecules simultaneously is thus of considerable interest for the treatment of this often fatal condition [16].…”

Section: Resultsmentioning

confidence: 99%

Interleukin‐10 inhibits endotoxin‐induced tissue factor mRNA production by human monocytes

et al. 1993

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In Gram-negative septic shock, human monocytes synthesize and express on their cytoplasmic membrane tissue factor (TF), a potent activator of the coagulation cascades. The role of TF in triggering disseminated intravascular coagulation (DIC) in these patients appears to be clear. We report the suppressive effect of interleukin-10 (IL-10) on endotoxin-induced TF activity and antigen levels, and on the expression of TF mRNA levels in human monocytes. These results emphasize the potential therapeutic value of this cytokine in septic shock, a condition still associated with a high mortality rate.

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“…However, in sepsis‐induced DIC, a decrease in AT activity is frequently observed27, 28, 29, 30 and is associated with high mortality rates 31, 32. Several RCTs to investigate the effects of high‐dose AT administration in patients with sepsis have been carried out 4, 33, 34, 35, 36.…”

Section: Antithrombinmentioning

confidence: 99%

A summary of the Japan septic disseminated intravascular coagulation study

Hayakawa

Ono

2018

Acute Medicine & Surgery

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Over the past few decades, the large, international, randomized controlled trials of anticoagulant therapies for patients with sepsis have not yielded any improvement in mortality rates. However, in Japan, anticoagulant therapies are administered for sepsis patients with disseminated intravascular coagulation (DIC), but not for sepsis patients without DIC. Furthermore, epidemiological data regarding sepsis in Japan are scarce. Therefore, a nationwide multicenter retrospective observational study, the Japan Septic Disseminated Intravascular Coagulation (JSEPTIC DIC) study, was undertaken. The JSEPTIC DIC study enrolled 42 intensive care units and included 3,195 patients with sepsis. The results of the JSEPTIC DIC study indicated the following: (i) anticoagulant therapy may be effective in sepsis‐induced DIC patients at high risk for death, (ii) recombinant human soluble thrombomodulin administration and antithrombin supplementation are associated with survival benefits in patients with sepsis‐induced DIC.

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Septic Shock, Multiple Organ Failure, and Disseminated Intravascular Coagulation

Cited by 641 publications

References 24 publications

Several Cytokines and Protein C Levels with the Apache II Scoring System for Evaluation of Patients with Sepsis

Several Cytokines and Protein C Levels with the Apache II Scoring System for Evaluation of Patients with Sepsis

Interleukin‐10 inhibits endotoxin‐induced tissue factor mRNA production by human monocytes

A summary of the Japan septic disseminated intravascular coagulation study

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