The issues of the pathogenesis of coagulopathy in septic shock

DOI

https://dx.doi.org/10.18565/aig.2019.10.13-21

Makatsariya A.D., Serov V.N., Sukontseva T.A., Bitsadze V.O., Shkoda A.S., Khizroeva D.Kh., Vorobyev A.V.
1) Department of Obstetrics and Gynecology, Institute of Children’s Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow, Russia; 2) Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow, Russia; 3) Academician I.P. Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia; 4) L.A. Vorokhobov City Clinical Hospital Sixty-Seven, Moscow Healthcare Department, Moscow, Russia

The paper gives data on the pathogenesis of disorders in the hemostatic system in the presence of septic conditions, which is associated with coagulation activation at the site of primary infection and the subsequent development of coagulopathy. The clinical presentation of sepsis consists of the primary septic focus and concomitant syndromes: disseminated intravascular coagulation (DIC), acute respiratory distress syndrome, and shock with damage to the corresponding organs and tissues. Activation of hemostasis occurs in septic conditions when the endothelium is damaged by toxins of a pathogenic microorganism, activated immunocompetent blood cells, and pro-inflammatory cytokines, which results in the synthesis and release of tissue factor. Moreover, a decrease in the level of ADAMTS-13 and a subsequent increase in that of von Willebrand factor is also part of the pathogenesis of sepsis, which in turn can lead to thrombotic microangiopathy. The severity of DIC and thrombotic microangiopathy in sepsis is a governing factor of the severity of the condition and largely determines an unfavorable, including fatal, outcome.

sepsis

septic shock

systemic inflammatory response syndrome

coagulopathy

catastrophic antiphospholipid syndrome

thrombotic microangiopathy

hemostatic disorders

thrombophilia

Full text (in Russian)

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Received 03.09.2019

Accepted 04.10.2019

Aleksander D. Makatsariya, MD, PhD, corresponding member of the Russian Academy of Sciences, Professor, Head of the Department of Obstetrics and Gynecology,
The First I.M. Sechenov Moscow State Medical University. E-mail: gemostasis@mail.ru
Vladimir N. Serov, MD, PhD, Professor, Academician of the Russian Academy of Sciences, Principal Researcher, Research Center for Obstetrics, Gynecology, and Perinatology; President of Russian Society of Obstetricians and Gynecologists. Тel.: +7(495) 438-72-87. E.mail: v_serov@oparina4.ru.
Tatiana A. Sukontseva, student of The First I.P. Pavlov St. Petersburg State Medical University, Russia. E-mail: tatiana.sukontseva@gmail.com
Viktoria O. Bitsadze, MD, PhD, Professor of the Russian Academy of Sciences, Professor of the Department of Obstetrics and Gynecology, The First I.M. Sechenov Moscow State Medical University. E-mail: gemostasis@mail.ru
Andrei S. Skoda, MD, PhD, professor, chief physician of the L.A. Vorokhobov City Clinical Hospital No.67, Moscow Department of Health. Tel .: +7 (495) 530-30-71;
e-mail: 67gkb@mail.ru; 123423, Russia, Moscow, ul. Salam Adil, d. 2/44.
Jamilya Khizroeva, MD, PhD, Professor of the Department of Obstetrics and Gynecology, The First I.M. Sechenov Moscow State Medical University.E-mail: gemostasis@mail.ru
Alexander V. Vorobyev, MD, PhD, Associate Professor of the Department of Obstetrics and Gynecology, The First I.M. Sechenov Moscow State Medical University.
E-mail: alvorobev@gmail.com

For citation: Makatsariya A.D., Serov V.N., Sukontseva T.A., Bitsadze V.O., Shkoda A.S., Khizroeva D.Kh., Vorobyev A.V. The issues of the pathogenesis of coagulopathy in septic shock.
Akusherstvo i Ginekologiya/ Obstetrics and gynecology. 2019; 10: 13-21. (In Russian).
https://dx.doi.org/10.18565/aig.2019.10.13-21

The issues of the pathogenesis of coagulopathy in septic shock

Makatsariya A.D., Serov V.N., Sukontseva T.A., Bitsadze V.O., Shkoda A.S., Khizroeva D.Kh., Vorobyev A.V.

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