Back
A NEW LOOK AT THE PATHOPHYSIOLOGICAL PROCESSES, STAGING AND DIAGNOSIS OF SEVERE SEPSIS (TRANSLATION FROM PRECLINICAL STUDIES IN PRIMATES TO PATIENTS WITH SEVERE SEPSIS
Abstract number: P-W-048
Taylor Jr.1 F.B.
1Cardiovascular Biology, Oklahoma Medical Research Foundation, Oklahoma City, United States
How-to-cite Taylor Jr. FB. A NEW LOOK AT THE PATHOPHYSIOLOGICAL PROCESSES, STAGING AND DIAGNOSIS OF SEVERE SEPSIS (TRANSLATION FROM PRECLINICAL STUDIES IN PRIMATES TO PATIENTS WITH SEVERE SEPSIS. J Thromb Haemost 2007; 5 Supplement 2: P-W-048
Abstract
Introduction: Sepsis is an acute inflammatory microvascular disease leading to failure of other organs. Severe sepsis can exhibit several clinical variants depending on the nature and intensity of the stimulus and status of the host. Improvement of the efficacy of therapeutic agents such as activated protein C will depend on better targeting of the several possible pathophysiological processes leading to organ failure. Optimal treatment requires identifying the dominant process as well as estimating severity and predicting survival.
This review examines the natural history of sepsis in the baboon challenged with different E.coli concentrations chosen to mimic the clinical variants. We recognize two broad pathophysiologic processes that either singly or in combination can drive progressive organ failure, increased vascular permeability, consumptive coagulopathy and ischemia reperfusion.
Methods: Using two global biomarkers of hemostatic activity (prothrombin time and platelet count), we observed that consumptive coagulopathy could be distinguished from ischemia reperfusion in the baboon model of progressive organ failure. This finding arose from earlier studies of the natural course of sepsis in which two stages (a coagulopathic followed by an ischemia reperfusion process) were observed in the sublethal responses of baboons to E.coli and humans to endotoxin. The signatures of these two processes were used to stratify a large (40%) subgroup of patients presenting with progressive organ failure.
Results: The ischemia reperfusion signature was distinct from the coagulopathic signature and was observed in both the survivor and non-survivor sets of this progressive organ failure group. A significant increase in incidence of ischemia reperfusion over 48 hours favoring the survivor group was observed.
Conclusions: see Results
References: Kinasewitz GT, et al. Prognostic value of a simple evolving disseminated intravascular coagulation score in patients with severe sepsis. Crit Care Med 2005; 33(10)2214-2221
To cite this abstract use the following format:
Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number
Session Details
| Date: |
01/08/2007
|
| Time: |
00:00-00:00
|
| Session name: |
XXIst ISTH Congress |
| Subject: |
|
| Location: |
Oxford, UK |
| Presentation type: |
|
| Back to top |
|
