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Printable Handouts
Navigable Slide Index
- Introduction
- Coagulopathy in systemic inflammatory states
- Laboratory findings: the tip of the iceberg
- DIC (1)
- DIC (2)
- First DIC clinical description
- The clinical picture of DIC
- Involvement of microvascular thrombosis in DIC (1)
- Involvement of microvascular thrombosis in DIC (2)
- Inflammation, thrombosis and multi organ failure
- The link between inflammation and coagulation
- In vivo expression of tissue factor
- TF as the initiator of coagulation activation
- The role of platelet-vessel wall interaction
- ADAMTS13 deficiency in patients with sepsis (1)
- ADAMTS13 deficiency in patients with sepsis (2)
- ADAMTS13 deficiency in patients with sepsis (3)
- Platelets as immune and inflammatory effectors
- Platelet activation during immune response
- Coagulation can modulate inflammatory activity
- Pathways during inflammation and coagulation
- The role of PARs in inflammation and coagulation
- Neutrophil extracellular traps (NETs)
- Heparin prevents histone-mediated toxicity
- Regulators of the coagulation system
- Anticoagulation systems effects on inflammation
- Antithrombin
- The importance of activated protein C
- Downregulation of thrombomodulin in sepsis (1)
- Downregulation of thrombomodulin in sepsis (2)
- Downregulation of thrombomodulin in sepsis (3)
- Restoration of thrombin generation with protein C
- Protein C deficient mice and DIC
- Sepsis in protein C deficient mice
- Tissue factor is not balanced by TFPI
- Fibrinolytic response upon endotoxemia
- PAI-1 in patients with DIC
- Pathogenesis mechanisms in DIC
- Using the knowledge to design better therapies
- The diagnosis of DIC
- Soluble fibrin as a marker for coagulation
- Fibrin as a marker for DIC diagnosis
- Guidelines for diagnosis and management of DIC
- Protein C deficient mice and DIC
- Prospective validation of ISTH DIC scoring system
- Survival rates for DIC patients
- Fibrinogen as a predictive value of DIC score
- Point of care testing
- Anticoagulants in sepsis
- Efficacy and safety of heparin in DIC
- Prophylactic heparin in patients with severe sepsis
- Equivalence analysis of 28-day mortality
- Subgroup: patients already on heparin
- Restoring the levels of protein C in severe sepsis
- Drotrecogin α beneficial effect in patients with DIC
- Overt DIC as a predictor of clinical benefit
- Treatment effects of high-dose antithrombin
- Downregulation of thrombomodulin in sepsis
- Recombinant human soluble thrombomodulin
- Retrospective studies with thrombomodulin
- Promising results with thrombomodulin
- Conclusion
Topics Covered
- Coagulopathy in systemic inflammatory states
- The clinical picture of DIC
- Inflammation leads to coagulation
- The role of tissue factor in coagulation and inflammation
- ADAMTS13 deficiency
- Coagulation leads to inflammation
- The role of Protease-Activated Receptors in inflammation and coagulation
- Neutrophil extracellular traps (NETs)
- Anticoagulation systems effects on inflammation
- Pathogenetic mechanisms in DIC
- The diagnosis of DIC
- Treatment
Talk Citation
Levi, M. (2016, October 31). Coagulation in sepsis [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 14, 2024, from https://doi.org/10.69645/DGYA4634.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Marcel Levi has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
A selection of talks on Haematology
Transcript
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0:00
Good day, this is Marcel Levi,
from the Academic Medical Center
of the University of Amsterdam
in the Netherlands.
And I'm going to present a talk
on the coagulopathy
associated with sepsis.
0:13
In systemic inflammatory states,
as may be the case in patients
with severe infection
or even sepsis,
there is always some degree
of coagulation activation.
This can be detected
when you use sensitive assays
for molecular markers
of activated coagulation factors
or pathways.
But if it's sufficiently severe,
you're also going to see
laboratory abnormalities
in routine coagulation tests
like the platelet count
or prolongation
of the global clotting tests,
APTT and PT,
and in its most extreme form,
disseminated intravascular
coagulation may occur.
0:51
Actually what we see
in the laboratory,
especially
in the routine laboratory,
is probably
the tip of the iceberg.
Under the surface, there is
a lot of coagulation activation
that may be clinically relevant,
present in patients
with severe infection and sepsis
and the associated
systemic
inflammatory states.
1:11
Disseminated
intravascular coagulation
is often seen
as a confusing clinical entity.
This is also reflected
by the various names
that can be found
for the condition in textbooks.
Are they surgical
or intensive care textbooks
or textbooks of hematology
and internal medicine?
But actually all these name
points to the same
clinical entity
that we nowadays call
disseminated
intravascular coagulation.
1:37
DIC has been with us
for centuries
and it's probably
the first description stems
from many, many years ago.
In the first
experimental setting
with what we would now
call experimental DIC
was described in 1834 in Paris,
when injection of brain material
into animals
resulted in a widespread
activation of coagulation,
resulting in clot formation
and also death of the animals.