title: Association between the severity of sepsis and the changes in hemostatic molecular markers and vascular endothelial damage markers.
abstract: It is well known that disorders of coagulation and fibrinolysis play a major role in the development of organ dysfunction during sepsis. Furthermore, the importance of the early initiation of anticoagulation therapy for severe cases has been emphasized based on the success of recent clinical trials. The purpose of this study is to search for useful markers for predicting organ dysfunction. Plasma samples were prospectively collected from 78 patients within 48 h after the onset of sepsis. Hemostatic markers and endothelial damage markers were compared between the patients with and without organ dysfunction. The WBC and platelet counts were not different between the groups. In contrast, fibrin/fibrinogen degradation products, D-dimer, thrombin-antithrombin complex, plasmin alpha2-antiplasmin complex, soluble fibrin, and total plasminogen activator inhibitor-1 were significantly higher, and the antithrombin activity and protein C levels were lower in the patients with organ dysfunction. Thus, the changes in the hemostatic molecular markers were associated with organ dysfunction from an early stage of sepsis, and antithrombin and protein C activities were found to be the most reliable markers.
authors.affiliation: Department of Surgery, Juntendo Urayasu Hospital, Juntendo University School of Medicine, Urayasu, Chiba 279-0021, Japan. iba-jun@umin.ac.jp
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Iba
authors.forename: Akio
authors.initials: A
authors.lastname: Kidokoro
authors.forename: Masaki
authors.initials: M
authors.lastname: Fukunaga
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Sugiyama
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sawada
authors.forename: Hisaaki
authors.initials: H
authors.lastname: Kato
mesh_terms: D000328:Adult; D000368:Aged; D000990:Antithrombin III; D000991:Antithrombins / Q000096:biosynthesis; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001772:Blood Cell Count; D001780:Blood Coagulation Tests; D004730:Endothelium, Vascular / Q000166:cytology*; D005260:Female; D005337:Fibrin / Q000096:biosynthesis; D005338:Fibrin Fibrinogen Degradation Products / Q000096:biosynthesis; D006487:Hemostasis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000097:blood; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D012372:ROC Curve; D018805:Sepsis / Q000097:blood* / Q000276:immunology / Q000473:pathology*; D013997:Time Factors; D000979:alpha-2-Antiplasmin / Q000096:biosynthesis
chemical_list: D000991:Antithrombins; D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D017395:Plasminogen Activator Inhibitor 1; D000979:alpha-2-Antiplasmin; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; D000990:Antithrombin III; D005337:Fibrin; D010447:Peptide Hydrolases