Patients with sepsis commonly require invasive procedures and frequently have an associated coagulopathy.1 In a recent observational survey conducted in Japan, among 1,895 patients with sepsis treated in intensive care units, 29% were diagnosed with sepsis-induced coagulopathy, a term that is synonymous with disseminated intravascular coagulation (DIC) as defined by laboratory criteria.2 In patients with sepsis, the imbalance in clot generation (coagulation) and clot breakdown (fibrinolysis) is a pivotal response that occurs due to host defense mechanisms but is associated with the development of organ dysfunction.3,4 In a prior Anesthesiology editorial, Gropper suggested that “all of these conditions (in sepsis) likely share a common pathway for the development of multiple system organ failure: diffuse activation of endothelium by proinflammatory cytokines, leukocytes, and other proteins. Activated endothelium becomes prothrombotic in these conditions,...
Sepsis-induced Coagulopathy and Disseminated Intravascular Coagulation
This article is featured in “This Month in Anesthesiology,” page 1A.
Submitted for publication June 24, 2019. Accepted for publication December 6, 2019. Published online first on January 22, 2020.
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Toshiaki Iba, Jerrold H. Levy; Sepsis-induced Coagulopathy and Disseminated Intravascular Coagulation. Anesthesiology 2020; 132:1238–1245 doi: https://doi.org/10.1097/ALN.0000000000003122
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