Patients with sepsis commonly require invasive procedures and frequently have an associated coagulopathy. 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. 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,...

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