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Enigmatic role of coagulopathy among sepsis survivors: a review of coagulation abnormalities and their possible link to chronic critical illness
  1. Leah K Winer1,
  2. Christen Salyer1,
  3. Nadine Beckmann1,
  4. Charles C Caldwell1,2,
  5. Vanessa Nomellini2,3
  1. 1Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
  2. 2Department of Research, Shriners Hospitals for Children Cincinnati, Cincinnati, Ohio, USA
  3. 3Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, University of Cincinnati Academic Health Center, Cincinnati, Ohio, USA
  1. Correspondence to Dr Vanessa Nomellini; nomellva{at}ucmail.uc.edu

Abstract

There are sparse clinical data addressing the persistence of disordered coagulation in sepsis and its role in chronic critical illness. Coagulopathy in the absence of anticoagulant therapy and/or liver disease can be highly variable in sepsis, but it tends to be prolonged in patients in the intensive care unit with a length of stay greater than 14 days. These coagulation abnormalities tend to precede multisystem organ failure and persistence of these coagulation derangements can predict 28-day mortality. The studies evaluated in this review consistently link sepsis-associated coagulopathy to poor long-term outcomes and indicate that disordered coagulation is associated with unfavorable outcomes in chronic critical illness. However, the causative mechanism and the definitive link remain unclear. Longer follow-up and more granular data will be required to fully understand coagulopathy in the context of chronic critical illness.

  • sepsis
  • blood coagulation
  • multiple organ failure
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • LKW and CS contributed equally.

  • Contributors LKW and VN conceived the presented ideas. LKW and CS wrote the article with support from NB, CCC and VN. All authors provided critical feedback and helped shape the research, analysis and article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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