Thrombocyte and Erythrocyte Indices in Sepsis and Disseminated Intravascular Coagulation

Serefden Acikgoz,Vildan Sumbuloglu,Berrak Guven,Zeynep Eskici,Deniz Akduman,Füsun Comert,Gorkem Mungan,Murat Can

doi:10.2478/v10011-011-0043-1

Abstract

Thrombocyte and Erythrocyte Indices in Sepsis and Disseminated Intravascular CoagulationSepsis is the inflammatory response against infection. The existence of DIC during sepsis indicates a poor prognosis and coagulation abnormalities and thrombocytopenia may exist. The aim of this study was to investigate platelet and erythrocyte indices in sepsis patients with DIC and without DIC. In both groups coagulation tests, platelet count and indices, erythrocyte count and indices were retrospectively analysed. In the sepsis plus DIC patients the prothrombin time and D-dimer values were found significantly higher and fibrinogen, platelet and plateletcrit were found significantly lower than in the sepsis without DIC group. The analysis of mean platelet volume, platelet distribution width, erythrocyte count and indices revealed no significant differences between the two groups. These results showed us that the depression of bone marrow in septic patients with DIC and without DIC did not differ. The activation of the coagulation system might probably be the cause of thrombocyte depletion in DIC.

Highlights

Disseminated intravascular coagulation (DIC) is a thrombohemorrhagic disorder secondary to an underlying clinical condition [1]
Cytokines secreted in sepsis lead to an increase in thrombin formation via release of tissue factor (TF) from the endothelium and monocytes, and disruption of the fibrinolytic system via stimulation of plasminogen activator inhibitor-1 (PAI-I) from the endothelium and platelets [7, 8]
Coagulation abnormalities and thrombocytopenia often emerge in severe sepsis and a clinical picture ranging from minor alterations to DIC and disseminated microvascular thrombosis might be observed [14]

Summary

Introduction

Disseminated intravascular coagulation (DIC) is a thrombohemorrhagic disorder secondary to an underlying clinical condition [1]. This is a frequent complication among patients in the intensive care unit and has a high rate of mortality [2]. DIC might emerge in patients with sepsis, malignity, trauma, hepatocellular disorders, vascular abnormalities, placental. Sepsis has been defined as the systemic inflammatory reaction against infection and comes first among the causes of DIC [3, 5, 6]. Cytokines secreted in sepsis lead to an increase in thrombin formation via release of tissue factor (TF) from the endothelium and monocytes, and disruption of the fibrinolytic system via stimulation of plasminogen activator inhibitor-1 (PAI-I) from the endothelium and platelets [7, 8]. The anticoagulant system is disrupted in septic patients due to the low levels of the thrombin inhibitor anti-thrombin III, and activation of Protein C which is the inhibitor of Factor Va and VIIIa [7, 8]

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