The effect of sepsis and its inflammatory response on mechanical clot characteristics: a prospective observational study
Davies, Gareth R.
Mills, Gavin M.
Evans, Phillip Adrian
MetadataShow full item record
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.
Intensive Care Medicine;
Davies, G., Pillai, S., Lawrence, M., Mills, G., Aubrey, R., D’Silva, L., Battle, C., Williams, R., Brown, R., Thomas, D., Morris, K. & Evans, P. (2016) 'The effect of sepsis and its inflammatory response on mechanical clot characteristics: a prospective observational study', Intensive Care Medicine, 42(12), pp.1990-1998
Article published in Intensive Care Medicine available at https://doi.org/10.1007/s00134-016-4496-z
Showing items related by title, author, subject and abstract.
The effect of different strains of LPS on the surface expression of CD14 and TLR4 in MonoMac6 cells Raybould, David (Cardiff Metropolitan University, 2011)Toll-like Receptors (TLRs) recognise microbial pathogen-associated molecular patterns (PAMPs) and are a vital component of the innate immune system. TLR4, along with mCDl4 and MD2, recognises lipopolysaccharide (LPS) ...
Jones, Liam (Cardiff Metropolitan University, 2011)Lipopolysaccaride (LPS) is one of the main components of the Gram negative cell wall, it gets released into the blood stream when bacterial cell are destroyed or lysed by the immune system. If the levels are allowed to ...
Surface expression of CD14, TLR4 and TLR2 and cytokine release by Monomac-6 cells in response to Lipopolysaccharide and Pam3 stimulation Silas, Shefina (Cardiff Metropolitan University, 2010)Sepsis still remains the most common cause of death of the patients in the intensive care unit. Therefore, investigation of the mechanisms behind the recognition of bacterial structural components can be used to determine ...