Activated protein C does not increase in the early phase of trauma with disseminated intravascular coagulation: comparison with acute coagulopathy of trauma-shock.

Subrina Jesmin,Takeshi Wada,Mineji Hayakawa,Atsushi Sawamura,Satoshi Gando

doi:10.1186/s40560-015-0123-2

Abstract

We hypothesized that activated protein C does not increase in disseminated intravascular coagulation (DIC) after trauma and that the same is true for acute coagulopathy of trauma-shock (ACOTS). Activated protein C levels were prospectively measured in 57 trauma patients: 30 with DIC and 27 without DIC. Normal to more decreased activated protein C levels were observed in DIC patients than in the controls and non-DIC patients. The activated protein C levels in ACOTS patients were similar to those in DIC patients. In conclusion, activated protein C does not increase in either DIC or ACOTS in the early phase of trauma.

Highlights

An impairment of the anticoagulation pathways, including protein C and thrombomodulin system, has been confirmed in disseminated intravascular coagulation (DIC), which suggests lower levels or dysfunction of activated protein C (APC), leading to systemic thrombin generation [1]
The same was true in acute coagulopathy of trauma-shock (ACOTS) patients
The overt DIC scores based on the International Society on Thrombosis and Haemostasis (ISTH) were calculated

Summary

Introduction

An impairment of the anticoagulation pathways, including protein C and thrombomodulin system, has been confirmed in disseminated intravascular coagulation (DIC), which suggests lower levels or dysfunction of activated protein C (APC), leading to systemic thrombin generation [1]. Higher levels of APC and newly synthesized thrombomodulin with full function play pivotal roles in the development of thrombin shutoff in acute coagulopathy of trauma-shock (ACOTS) [2, 3].

Objectives

Methods

Conclusion