A Armaganidis

A Gialeraki

E Merkouri

E Paramythiotou

F Frantzeskaki

I Dimopoulou

M Theodorakopoulou

O Travlou

Intensive Care Medicine Experimental

PubMed

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POSTER PRESENTATION Open AccessCoagulation disorders and the role of tissuefactor and tissue factor pathway inhibitor incritically ill patientsF Frantzeskaki1*, E Merkouri2, A Gialeraki3, E Paramythiotou1, M Theodorakopoulou1, O Travlou2, A Armaganidis1,I Dimopoulou1From ESICM LIVES 2015Berlin, Germany. 3-7 October 2015IntroductionTissue factor (TF), plays a key role in pathophysiologyof disseminated intravascular coagulation (DIC) andmultiple organ dysfunction syndrome. Tissue factorpathway inhibitor (TFPI) regulates tissue factor activity.Several studies in septic patients have shown that TFproduction exceeds TFPI production,promoting a pro-thrombotic state.ObjectiveThe aim of our study was to record coagulation disor-ders, during the course of different stages of sepsis. Wealso measured TF and TFPI levels, while we investigatedthe possible correlation of these parameters with morbid-ity and mortality.MethodsThis prospective observational study was conducted in a19-bed polyvalent adult intensive care unit of the “Atti-kon” University Hospital, between November 2012 andJune 2013.TF and TFPA levels were recorded on day ofstudy entry (protocol day 0) and further followed once aweek (days 7 and 14 or until they were discharged fromICU or until death). Tissue factor activity (TFa) was mea-sured by homemade test of Stago Diagnostica. TFPI wasmeasured by immunoenzyme assay ELISA standardphase. Disease severity at study entry according to AcutePhysiology and Chronic Health Evaluation (APACHE II)score, the degree of organ dysfunction quantified by theSequential Organ Failure Assessment (SOFA) score, thepresence of DIC, as expressed by DIC score, the sepsisstage, and the respective laboratory data, were recordedon each protocol day.ResultsTwenty nine (19) mechanically ventilated septic patientswere enrolled in the study. Among them, 12 patients sur-vived (63%) during ICU staying. Survivors were signifi-cantly younger than non-survivors (p = 0.03), with higherdisease severity as expressed by APACHE II (p = 0.008).DIC score was significantly higher in non survivors (p =0.01). Mortality was higher in patients with severe sepsis/septic shock, as compared to patients with sepsis/SIRS(p = 0.02). The latter group of patients showed signifi-cantly lower DIC and SOFA scores. TFa has higher in nonsurvivors (p = 0.007). It also showed a trend to be higherin patients with severe sepsis/septic shock, while the differ-ence became significant on study day 14. TFPI tended tobe higher in the same group of patients. A significant cor-relation was observed between TFPI and INR values onstudy day 0 (Pearson coefficient = 0.9, p = 0.001), betweenDIC score and APACHE II, and DIC score with SOFA.ConclusionsThe activation of coagulation in sepsis, as expressed byDIC score, is significantly correlated to organ dysfunctionand subsequent mortality. The observed imbalancebetween TF and TFPI might have a prognostic value.Larger studies are needed, in order to confirm theseresults, and lead to possible therapeutic considerationstargeting to sepsis associated DIC and organ dysfunction.Authors’ details1Attikon University Hospital, Intensive Care Unit, Athens, Greece. 2AthensMedical Center, Psychiko Clinic, Haemostasis and Anticoagulation Laboratory,1Attikon University Hospital, Intensive Care Unit, Athens, GreeceFull list of author information is available at the end of the articleFrantzeskaki et al. Intensive Care Medicine Experimental 2015, 3(Suppl 1):A297http://www.icm-experimental.com/content/3/S1/A297© 2015 Frantzeskaki et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License(http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, providedthe original work is properly cited.Athens, Greece. 3Attikon University Hospital, Haematologic Laboratory,Athens, Greece.Published: 1 October 2015Reference1. Van der Poll T, Herwald H: The coagulation system and its function inearly immune defense. Thrombosis and haemostasis 2014, 112(1).doi:10.1186/2197-425X-3-S1-A297Cite this article as: Frantzeskaki et al.: Coagulation disorders and the roleof tissue factor and tissue factor pathway inhibitor in critically illpatients. Intensive Care Medicine Experimental 2015 3(Suppl 1):A297.Submit your manuscript to a journal and benefi t from:7 Convenient online submission7 Rigorous peer review7 Immediate publication on acceptance7 Open access: articles freely available online7 High visibility within the fi eld7 Retaining the copyright to your article    Submit your next manuscript at 7 springeropen.comFrantzeskaki et al. Intensive Care Medicine Experimental 2015, 3(Suppl 1):A297http://www.icm-experimental.com/content/3/S1/A297Page 2 of 2

Coagulation disorders and the role of tissue factor and tissue factor pathway inhibitor in critically ill patients

http://dx.doi.org/10.1186/2197-425X-3-S1-A297

Coagulation disorders and the role of tissue factor and tissue factor pathway inhibitor in critically ill patients

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