title: [Changes in coagulation in patients with sepsis].
abstract: Aiming to know the coagulation disorders that occur in patients with sepsis, a retrospective study of 75 such patients hospitalized in an Intensive Care Unit was performed. The coagulation profile requested by the attending physician, that included platelet count, prothrombin time, partial thromboplastin time, thrombin time, protamine sulphate test, fibrinogen and euglobin lysis time, was analyzed. Fourteen patients that were receiving prophylactic subcutaneous heparin were excluded from further analysis. Of the 61 remaining patients, 23 had hemorrhagic manifestations and 94.4% of these had multiple alterations in coagulation parameters. Eighty one percent of patients had abnormal prothrombin time and 73% thrombocytopenia. Isolated alterations were infrequent and consisted in thrombocytopenia (3.7%) and fibrinogen elevation (1.9%). Fifty two percent of patients had shock and they had significantly lower platelet counts and higher prothrombin and thrombin times than patients without hemodynamic disturbances. Global mortality was 63.9%. No relation between coagulation disturbances and mortality was observed. Likewise, no differences in mortality between patients with or without shock was observed. It is concluded that coagulation is frequently disturbed in patients with sepsis, even without clinical hemorrhagic symptoms, that these abnormalities are more marked in patients in shock and that 53% of these are consistent with intravascular coagulation.
authors.affiliation: Departamento de Medicina, Servicio de Hematología, Hospital Clínico Universidad de Chile, Santiago de Chile.
authors.forename: G
authors.initials: G
authors.lastname: Alarcón
authors.forename: P
authors.initials: P
authors.lastname: Fardella
authors.forename: G
authors.initials: G
authors.lastname: Conte
authors.forename: V
authors.initials: V
authors.lastname: Vargas
authors.forename: X
authors.initials: X
authors.lastname: Parada
authors.forename: M
authors.initials: M
authors.lastname: Cuneo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000097:blood* / Q000401:mortality; D001778:Blood Coagulation Disorders / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D001780:Blood Coagulation Tests; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000097:blood
chemical_list: D005340:Fibrinogen
vernacular_title: Alteraciones de la coagulación en pacientes con sepsis.