Journal article 1612 views 348 downloads
The effect of sepsis and its inflammatory response on mechanical clot characteristics: a prospective observational study
,
Suresh Pillai,
Matthew Lawrence,
Gavin M. Mills,
Robert Aubrey,
Lindsay D´Silva,
Ceri Battle,
Rhodri Williams ,
Rowan Brown ,
Dafydd Thomas,
Keith Morris,
Adrian Evans
Intensive Care Medicine, Volume: 42, Issue: 12, Pages: 1990 - 1998
Swansea University Authors:
Gareth Davies , Matthew Lawrence, Lindsay D´Silva, Rhodri Williams , Rowan Brown , Adrian Evans
-
PDF | Accepted Manuscript
Download (904.51KB)
DOI (Published version): 10.1007/s00134-016-4496-z
Abstract
Purpose: Sepsis and its progression are known to have a major influence on the coagulation system. Current coagulation tests are of limited use when assessing coagulation in sepsis patients. This study aims to assess the potential for a new functional biomarker of clot microstructure, fractal dimens...
| Published in: | Intensive Care Medicine |
|---|---|
| ISSN: | 0342-4642 1432-1238 |
| Published: |
Springer Science and Business Media LLC
2016
|
| Online Access: |
Check full text
|
| URI: | https://cronfa.swan.ac.uk/Record/cronfa30088 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Abstract: |
Purpose: Sepsis and its progression are known to have a major influence on the coagulation system. Current coagulation tests are of limited use when assessing coagulation in sepsis patients. This study aims to assess the potential for a new functional biomarker of clot microstructure, fractal dimension, to identify changes in the mechanical properties of clot microstructure across the sepsis spectrum (sepsis, severe sepsis and septic shock). Methods: A total of 100 patients that presented acutely to a large teaching hospital were included in this prospective observational study (50 sepsis, 20 severe sepsis and 30 septic shock) against a matched control of 44 healthy volunteers. Fractal analysis was performed, as well as standard markers of coagulation, and six plasma markers of inflammation. Results: Fractal dimension was significantly higher in the sepsis and severe sepsis groups than the healthy control (1.78 ± 0.07 and 1.80 ± 0.05 respectively vs 1.74 ± 0.03) (p < 0.001), indicating a significant increase in mechanical clot strength and elasticity consistent with a hypercoagulable state. Conversely, fractal dimension was significantly lower in septic shock (1.66 ± 0.10, p < 0.001), indicating a significant reduction in mechanical clot strength and functionality consistent with a hypocoagulable state. This corresponded with a significant increase in the inflammatory response. Conclusions: This study confirms that clot microstructure is significantly altered through the various stages of sepsis. Of particular importance was the marked change in clot development between severe sepsis and septic shock, which has not been previously reported. |
|---|---|
| Keywords: |
sepsis; biomarkers; cogulation; clot microstructure |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Issue: |
12 |
| Start Page: |
1990 |
| End Page: |
1998 |