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Variation of endothelium‐related hemostatic factors during sepsis
Author(s) -
Vasileiadis Ioannis,
Politou Marianna,
Dimopoulos Stavros,
Roviikoletta,
Kyriakopoulou Magdalini,
Kyriakoudi Anna,
Tripodaki ElliSophia,
Koutsouri Theodora,
Terpos Evangelos,
Koulouris Nikolaos,
Koutsoukou Antonia
Publication year - 2018
Publication title -
microcirculation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.793
H-Index - 83
eISSN - 1549-8719
pISSN - 1073-9688
DOI - 10.1111/micc.12500
Subject(s) - thrombomodulin , sepsis , protein c , medicine , gastroenterology , von willebrand factor , coagulation , endothelial protein c receptor , endothelial activation , endothelium , septic shock , immunology , thrombin , platelet
Objective The thrombomodulin/protein C and VWF / ADAMTS ‐13 pathways are disturbed in sepsis and have been implicated in the coagulation disorders that characterize the septic syndrome. We aimed to assess the variation of these endothelial parameters during sepsis and their putative association with outcome, in critically ill, septic patients. Methods We monitored 34 septic patients, 23 of whom improved (group A) while 11 deteriorated (group B). We assessed ADAMTS ‐13 levels, VWF activity, soluble thrombomodulin, and protein C activity upon admission to the ICU (time point 0) and at the time of a change in the clinical condition (remission or deterioration, time point 1). Results In group A, thrombomodulin and VWF increased at time point 1 compared to time point 0 ( P = 0.011, P = 0.028, respectively). In group B, protein C and ADAMTS ‐13 significantly decreased ( P = 0.023, P = 0.026, respectively), while VWF , VWF / ADAMTS ‐13 ratio, and the thrombomodulin/protein C ratio increased ( P = 0.02, P = 0.002, P = 0.01, respectively). Protein C (> or ≤17%) and ADAMTS ‐13 percentage difference (> or ≤22%) were independently associated with sepsis outcome among the endothelial variables tested. Conclusions An ongoing endothelial/hemostatic disorder was established during sepsis, observed even at clinical improvement. Among the variables tested, protein C and ADAMTS ‐13 change were associated with outcome.