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Management Strategies in Septic Coagulopathy: A Review of the Current Literature

One of the ‘organs’ that can be affected by sepsis is the coagulation system. Coagulopathy in sepsis may take the form of sepsis-induced coagulopathy (SIC) or sepsis-associated disseminated intravascular coagulation (DIC). It is important to identify SIC early, as at this stage of coagulopathy antic...

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Autores principales: Czempik, Piotr F., Wiórek, Agnieszka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9858837/
https://www.ncbi.nlm.nih.gov/pubmed/36673595
http://dx.doi.org/10.3390/healthcare11020227
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author Czempik, Piotr F.
Wiórek, Agnieszka
author_facet Czempik, Piotr F.
Wiórek, Agnieszka
author_sort Czempik, Piotr F.
collection PubMed
description One of the ‘organs’ that can be affected by sepsis is the coagulation system. Coagulopathy in sepsis may take the form of sepsis-induced coagulopathy (SIC) or sepsis-associated disseminated intravascular coagulation (DIC). It is important to identify SIC early, as at this stage of coagulopathy anticoagulants may be of the greatest benefit. The most recent diagnostic scoring systems for septic coagulopathy come from the International Society on Thrombosis and Hemostasis and the Japanese Association for Acute Medicine. Recommendations regarding the management of septic coagulopathy differ between organizations. Moreover, septic coagulopathy is an area of intense research in recent years. Therefore we searched three databases to review the most recent management strategies in septic coagulopathy. The mainstream management strategies in septic coagulopathy include the causal treatment of sepsis, unfractionated heparin, low-molecular-weight heparin, antithrombin, and recombinant human thrombomodulin. The last two have been associated with the highest survival benefit. Nevertheless, the indiscriminate use of these anticoagulants should be avoided due to the lack of mortality benefit and increased risk of bleeding. The early diagnosis of SIC and monitoring of coagulation status during sepsis is crucial for the timely management and selection of the most suitable treatment at a time. New directions in septic coagulopathy include new diagnostic biomarkers, dynamic diagnostic models, genetic markers for SIC management, and new therapeutic agents. These new research avenues may potentially result in timelier SIC diagnosis and improved management of all stages of septic coagulopathy by making it more effective, safe, and personalized.
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spelling pubmed-98588372023-01-21 Management Strategies in Septic Coagulopathy: A Review of the Current Literature Czempik, Piotr F. Wiórek, Agnieszka Healthcare (Basel) Review One of the ‘organs’ that can be affected by sepsis is the coagulation system. Coagulopathy in sepsis may take the form of sepsis-induced coagulopathy (SIC) or sepsis-associated disseminated intravascular coagulation (DIC). It is important to identify SIC early, as at this stage of coagulopathy anticoagulants may be of the greatest benefit. The most recent diagnostic scoring systems for septic coagulopathy come from the International Society on Thrombosis and Hemostasis and the Japanese Association for Acute Medicine. Recommendations regarding the management of septic coagulopathy differ between organizations. Moreover, septic coagulopathy is an area of intense research in recent years. Therefore we searched three databases to review the most recent management strategies in septic coagulopathy. The mainstream management strategies in septic coagulopathy include the causal treatment of sepsis, unfractionated heparin, low-molecular-weight heparin, antithrombin, and recombinant human thrombomodulin. The last two have been associated with the highest survival benefit. Nevertheless, the indiscriminate use of these anticoagulants should be avoided due to the lack of mortality benefit and increased risk of bleeding. The early diagnosis of SIC and monitoring of coagulation status during sepsis is crucial for the timely management and selection of the most suitable treatment at a time. New directions in septic coagulopathy include new diagnostic biomarkers, dynamic diagnostic models, genetic markers for SIC management, and new therapeutic agents. These new research avenues may potentially result in timelier SIC diagnosis and improved management of all stages of septic coagulopathy by making it more effective, safe, and personalized. MDPI 2023-01-12 /pmc/articles/PMC9858837/ /pubmed/36673595 http://dx.doi.org/10.3390/healthcare11020227 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Czempik, Piotr F.
Wiórek, Agnieszka
Management Strategies in Septic Coagulopathy: A Review of the Current Literature
title Management Strategies in Septic Coagulopathy: A Review of the Current Literature
title_full Management Strategies in Septic Coagulopathy: A Review of the Current Literature
title_fullStr Management Strategies in Septic Coagulopathy: A Review of the Current Literature
title_full_unstemmed Management Strategies in Septic Coagulopathy: A Review of the Current Literature
title_short Management Strategies in Septic Coagulopathy: A Review of the Current Literature
title_sort management strategies in septic coagulopathy: a review of the current literature
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9858837/
https://www.ncbi.nlm.nih.gov/pubmed/36673595
http://dx.doi.org/10.3390/healthcare11020227
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