Severe sepsis, coagulation, and fibrinolysis: Dead end or one way?
François Fourrier, MD, FCCMIt was suggested more than 30 yrs ago that inhibition of the clotting cascade by natural anticoagulants could decrease the high mortality observed in patients suffering from severe sepsis and septic shock. Unfortunately, this therapeutic “paradigm” has led to a dead end, illustrated by the failure of all randomized trials
and the recent withdrawal of recombinant activated protein C. Should we now definitely give up trying to treat septic coagulation
disturbances or is there any therapeutic alternative?
(Crit Care Med 2012; 40:2704–2708)
Key Words: activated protein C; antithrombin; disseminated intravascular coagulation; fibrinolysis; innate immunity; natural anticoagulants; severe sepsis
Severe sepsis, coagulation, and fibrinolysis: Dead end or one way?
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