Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Lavranou Georgia-Athanasia
Dissertation committee:
Σπύρος Ζακυνθινός, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Σπύρος Μετζελόπουλος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Παρασκευή Κατσαούνου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Νικόλαος Κουλούρης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Χριστίνα Ρούτση, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ιωάννης Καλομενίδης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ιωάννης Βασιλειάδης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Διαταραχές της πήξης σε σηπτικούς ασθενείς της Μονάδας Εντατικής Θεραπείας
Translated title:
Coagulation disorders in septic patients of intesive care unit
Summary:
Background: Although the coagulation disorders and the immune/inflammatory response have been associated with the final outcome of patients with sepsis, their link with the temporary deterioration or improvement of patients with sepsis is unknown. The present study aimed to investigate whether the coagulation disorders and the immune/inflammatory response can predict the temporary clinical deterioration or improvement of patients admitted to the ICU due to suspected infection.
Methods: We prospectively included all consecutive patients who were admitted to the intensive care unit (ICU) of a general hospital over a period of 1,5 years with a suspected diagnosis of infection and were evaluated within the first 24 hours from admission. Blood levels of many cytokines and inflammatory and coagulation factors were measured and their predictive value was assessed by calculating the Area Under the Receiver Operating Characteristic (AUROC) curves. Results: Patients (n=102) were allocated in five groups, i.e., sepsis (n=14), severe sepsis (n=17), septic shock (n=28), Systemic Inflammatory Response Syndrome (SIRS) without infection (n=17), and trauma/surgery without SIRS or infection (n=26). In septic shock, coagulation factors FVII and FIX and Protein C had AUROCs 0.72, 0.67 and 0.78, respectively. In severe sepsis, Antithrombin III, Protein C, C-reactive protein, Procalcitonin and Thrombopoietin had AUROCs 0.73-0.75. In sepsis, Tumor Necrosis Factor a, and Interleukins 1β and 10 had AUROCs 0.66-0.72.
Conclusions: In patients admitted to the ICU with a suspected diagnosis of infection, coagulation factors FVII and FIX and coagulation inhibitors Antithrombin III and Protein C had substantial value in the sense of predicting temporary clinical improvement or deterioration in patients with severe sepsis or septic shock. Cytokine levels had a significant predictive value in patients with uncomplicated sepsis, while levels of C-reactive protein, Procalcitonin and Thrombopoietin were predictive in patients with severe sepsis.
Main subject category:
Health Sciences
Keywords:
Sepsis, Coagulation system, Cytokines
Number of references:
226
