Prognostic value of selected hypercoagulability markers in sepsis. A prospective study
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disseminated intravascular coagulation

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Osovskikh VV, Vasileva MS, Bautin AE, Kiseleva LN Prognostic value of selected hypercoagulability markers in sepsis. A prospective study. Annals of Critical Care. 2020;(3):66–73. doi:10.21320/1818-474X-2020-3-66-73.


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Introduction. Sepsis is a heterogeneous syndrome caused by an unbalanced host response to an infection, resulting in organ dysfunction. Disseminated intravascular coagulation (DIC) varies widely from 30 % to 60 % and depends on different scoring systems. An overt DIC easily identified, while the pre-existing phase of hypercoagulability can’t be detected by screening coagulation tests. Preventive DIC treatment is hardly possible without an early diagnostics.

Objectives. The aim of the study is identifying the hypercoagulabiliy markers in septic patients with hypercoagulability pattern on thromboelastometry (TEM) and matching them to the outcome.

Materiasl and methods. ROTEM screening of septic patients revealed 85 ones with pattern of hypercoagulability. Thrombin generation test with thrombomodulin, screening coagulation tests, anticoagulants levels and selected hypercoagulability markers were performed from frozen plasma samples. According to the outcome patients were divided to survivors and nonsurvivors.

Results. The survivors group included 62 patients and nonsurvivors — 19. Thrombin generation test revealed only 7 cases of hypercoagulability. There was no significant difference in endogenous thrombin potential 20 (10; 25) % vs 14 (10; 31) % and peak thrombin 8 (2,9; 16) % vs 7 (3; 18) % in survivors and nonsurvivors, respectively. Other significant differences between survivors vs nonsurvivors are: protein C 79,5 ± 28 % vs 64,9 ± 25 %, FVIII 226,4 ± 66 % vs 276,6 ± 94 % , von Willebrand factor 269 ± 129 % vs 435 ± 181 %, Аntithrombin 82 (60; 94) % vs 65 (41; 80) %, and D-dimer 2157 (1341; 3964) mcg/l vs 3253 (1911; 6914) mcg/l, respectively.

Conclusion. Septic patients with TEM criteria of hypercoagulability may have unique set of thrombophilia markers. Local screening coagulation tests do not affect the prognosis. Low level of protein C and antithrombin, as well as high FVIII, von Willebrand factor, D-dimer worsen outcome.
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  1. Singer M., Deutschman C.S., Seymour C.W., et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016; 315(8): 801. DOI: 10.1001/jama.2016.0287
  2. Iba T., Levy J.H., Raj A., et al. Advance in the Management of Sepsis-Induced Coagulopathy and Disseminated Intravascular Coagulation. J. Clinical Medicine. 2019; 8(5): 728. DOI: 10.3390/jcm805072
  3. Scarlatescu E., Juffermans N.P., Thachil J. The current status of viscoelastic testing in septic coagulopathy. Thrombosis Research. 2019; 183: 146–153. DOI: 10.1016/j.thromres.2019.09.029
  4. Saito S., Uchino S., Hayakawa M., et al. Epidemiology of disseminated intravascular coagulation in sepsis and validation of scoring systems. J. Critical Care. 2019; 50: 23–30. DOI: 10.1016/j.jcrc.2018.11.009.
  5. Ostrowski S.R., Windeløv N.A., Ibsen M., et al. Consecutive thrombelastography clot strength profiles in patients with severe sepsis and their association with 28-day mortality: A prospective study. J. Critical Care. 2013; 28(3): 317.e1–11. DOI: 10.1016/j.jcrc.2012.09.003
  6. Hincker A., Feit J., Sladen R.N., et al. Rotational thromboelastometry predicts thromboembolic complications after major non-cardiac surgery. Critical Care. 2014; 18(5): 549. DOI: 10.1186/s13054-014-0549-2
  7. Dimitrova-Karamfilova A., Patokova Y., Solarova T., et al. Rotational thromboelastography for assessment of hypercoagulation and thrombosis in patients with cardiovascular disease. J. Life Sci. 2012; 6: 28–35.
  8. Müller M.C., Meijers J.C., Vroom M.B., et al. Utility of thromboelastography and/or thromboelastometry in adults with sepsis: a systematic review. Critical Care. 2014; 18(1): R30. DOI: 10.1186/cc13721
  9. Gonzalez E., Kashuk J.L., Moore E.E., et al. Differentiation of Enzymatic from Platelet Hypercoagulability Using the Novel Thrombelastography Parameter Delta (Δ). J. Surgical Research. 2010; 163(1): 96–101. DOI: 10.1016/j.jss.2010.03.058
  10. Collins P.W., Macchiavello L.I., Lewis S.J., et al. Global tests of haemostasis in critically ill patients with severe sepsis syndrome compared to controls. British J. Haematology. 2006; 135(2): 220–227. DOI: 10.1111/j.1365-2141.2006.06281.x.
  11. Гамзатов Х.А., Гуржий Д.В., Лазарев С.М. и др. Использование теста генерации тромбина для оценки коагуляционной и антикоагулянтной активности системы гемостаза у больных с абдоминальным сепсисом. Вестник хирургии им. И.И. Грекова. 2013; 172(5): 66–70. DOI: 10.24884/0042-4625-2013-172-5. [Gamzatov Kh.A., Gurzhy D.V., Lazarev S.M., et al. Ispol’zovanie testa generacii trombina dlya ocenki koagulyacionnoj i antikoagulyantnoj aktivnosti sistemy gemostaza u bol’nyh s abdominal’nym sepsisom. Vestnik hirurgii im. I.I. Grekova. 2013; 172(5): 66–70. (In Russ)]
  12. Vincent J.-L., Francois B., Zabolotskikh I., et al. Effect of a Recombinant Human Soluble Thrombomodulin on Mortality in Patients With Sepsis-Associated Coagulopathy. JAMA. 2019; 321(20): 1993–2000. DOI: 10.1001/jama.2019.5358
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