Vascular bed-specific hemostasis: role of endothelium in sepsis pathogenesis.
OBJECTIVE
To examine the role of vascular bed-specific pathways in determining the hemostatic phenotype in sepsis.


METHODS
Published research and review articles related to hemostasis and endothelial cell biology.


METHODS
The results of published studies have been used to generate a hypothesis of vascular bed-specific hemostasis in sepsis.


CONCLUSIONS
In sepsis, coagulation is initiated by the extrinsic pathway and is amplified through the intrinsic pathway. In addition, the body's natural anticoagulant mechanisms are significantly dampened. Together, these changes result in a net imbalance of hemostasis. The nature of this imbalance varies from one vascular bed to the next according to the local set point of the endothelium. These concepts lay an important foundation for understanding the pathophysiology of sepsis.
Aird
W C
WC
Harvard Medical School and Beth Israel Medical School, Boston, MA 02215, USA. waird@caregroup.harvard.edu
D000818:Animals; D017209:Apoptosis; D001778:Blood Coagulation Disorders / Q000382:microbiology*; D001779:Blood Coagulation Factors / Q000502:physiology; D004195:Disease Models, Animal; D015195:Drug Design; D004730:Endothelium, Vascular / Q000502:physiology*; D005786:Gene Expression Regulation / Q000502:physiology; D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D010641:Phenotype; D020239:Receptor Cross-Talk / Q000502:physiology; D018805:Sepsis / Q000097:blood* / Q000150:complications* / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology; D015398:Signal Transduction / Q000502:physiology; D013927:Thrombosis / Q000209:etiology
D001779:Blood Coagulation Factors