СКРИНИНГ ГИПЕРКОАГУЛЯЦИОННЫХ НАРУШЕНИЙ ПРИ СЕПСИСЕ

Background. Overt disseminated intravascular coagulation (DIC) is independent risk factor in sepsis. Hypercoagulability, present in pre-DIC state, is hardly detected by available screening tests. T hromboelastometry (TEM) and thrombin generation test (TG) showed contradictory results in sepsis. Objectives . The aim of the study is to compare the screening potential of T EM, TG and local tests to detect hypercoagulability in sepsis. Design and methods . TEM screening of septic patients revealed hypercoagulability in 21 cases. T G test were performed along with screening coagulation tests and physiological anticoagulants. Results . There was no thrombin generation in 2 of 21 cases. Increased ETP and Peak revealed only in one case. T he degree of T M-modulated suppression of T G was abnormally low in 15 cases out of 19. Median ETP suppression was only 14% [8,8–24], Peak suppression was 8% [3,4–12,5]. T hus, T EM- identified hypercoagulability was confirmed by both T G and TM+TG tests only in 16 cases (84.2%). Dynamic T EM-criteria (CFT intem) highly correlated with ETP- and PTsuppression values. Conclusion . Hypercoagulability during sepsis is often due to abnormality in PC pathway. TEM appears to be sensitive POC tool to detect hypercoagulability in sepsis.