Modulators of Coagulation

摘要: Widespread intravascular coagulation is common in patients with sepsis. Coagulation abnormalities may result from exposure to endotoxin, tumor necrosis factor a or interleukin 1 release, the actions of more specific mediator, such as vascular permeability factor. The marked activation contact and systems; simultaneously, there decreased fibrinolysis depressed levels inhibitors systems. Multiple agents are being studied correct these abnormalities. Antithrombin III holds promise because it inhibits number factors important activation, not just thrombin. Plasminogen activators prove helpful increasing during sepsis; they have been associated rebound thrombin generation, however, plasminogen be most effective if used conjunction hirudin synthetic analogue. Bradykinin offset hypotension Protein C inhibit formation also complex activator inhibitor 1, thereby promoting fibrinolysis. Other that include α1-antitrypsin Pittsburgh, C1-esterase inhibitor, monoclonal antibodies factors, soybean trypsin inhibitors, thrombomodulin, prostaglandin I2, aprotinin. There no data support use heparin fibronectin, except limited circumstances. (Arch Intern Med. 1992;152:1381-1389)