H. Ostermann, H. Böhrer

Pathophysiologie und Diagnostik der Gerinnungsaktivierung bei Sepsis

Pathophysiology and diagnosis of coagulation activation in sepsis

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Keywords Critical care, Septicemia, Blood coagulation disorders, Diagnosis laboratory
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Summary Summary: Sepsis can be regarded as a systemic inflammatory reaction often accompanied by disseminated intravascular coagulation (DIC) which is supposed to be initiated by the expression of tissue factor for example by activated monocytes and endothelial cells. The hallmark of DIC is the intravascular generation of thrombin which leads to fibrin formation. Diagnosis of DIC is likely if sepsis is accompanied by the occurrence of intravascular soluble fibrin, a decrease in coagulation inhibitors (antithrombin) and thrombocytopenia. The most sensitive and specific test for DIC seems to be the detection of fibrin monomers. Clinical symptoms of DIC are caused simultaneously by comsumption of coagulation factors (bleeding) and intravascular thrombosis (organ failure).