2021
DOI: 10.1097/pcc.0000000000002759
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Fibrinolytic Impairment and Mortality in Pediatric Septic Shock: A Single-Center Prospective Observational Study*

Abstract: Fibrinolytic shutdown is associated with poor prognosis in adult sepsis, but data in the pediatric population are sparse. This study aimed to identify the association between impaired fibrinolysis and mortality in pediatric septic shock.

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Cited by 8 publications
(15 citation statements)
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“…Although there was some heterogeneity in the study population, dogs with sepsis were hypercoagulable and hypofibrinolytic relative to normal dogs. Depressed fibrinolysis combined with increased fibrinogen thus contributes to a prothrombotic risk in dogs with sepsis, as it does in humans ( 46 , 47 ). Our results support recommendations that sepsis represents a risk factor for thrombosis in dogs that can warrant thromboprophylaxis ( 48 , 49 ).…”
Section: Discussionmentioning
confidence: 99%
“…Although there was some heterogeneity in the study population, dogs with sepsis were hypercoagulable and hypofibrinolytic relative to normal dogs. Depressed fibrinolysis combined with increased fibrinogen thus contributes to a prothrombotic risk in dogs with sepsis, as it does in humans ( 46 , 47 ). Our results support recommendations that sepsis represents a risk factor for thrombosis in dogs that can warrant thromboprophylaxis ( 48 , 49 ).…”
Section: Discussionmentioning
confidence: 99%
“…The increase in PAI-1 levels consequently affects fibrinolysis more than does t-PA [ 70 ], and the higher the PAI-1 levels are during sepsis, the worse the outcome is, as seen in a study where PAI-1 levels were significantly higher in deceased patients [ 71 ]. In short, impaired fibrinolysis and fibrinolytic shut-down are not only associated with sepsis severity and mortality [ 70 ], but can also be used to discriminate between sepsis and SIRS in critically ill patients [ 72 , 73 ]. Furthermore, impaired fibrinolysis and fibrinolytic shut-down are also associated with increased markers of cellular damage and morbidity [ 74 ].…”
Section: Sepsismentioning
confidence: 99%
“…Further research should urgently focus on development of POC tests for etiological identification of infections and assays measuring immune response of patient to infection. Here the POC viscoelastic testing might be helpful in the future since impaired fibrinolysis or even fibrinolytic shutdown can discriminate between systemic inflammatory response syndrome (SIRS) and sepsis in critically ill patients [ 145 , 146 ]. Further technologies for new markers of immune response are in the development phase (neutrophil CD64 expression, microfluidic devices, cell motility, microRNA, cell stiffness, etc.…”
Section: Point-of-care Diagnostics In Haematology and Biochemistrymentioning
confidence: 99%