COAGULATION DISORDERS IN PATIENTS WITH SEPSIS

Aiming to know the coagulation disorders that occur in patients with s epsis, a retrospective study of 75 such patients hospitalized in an In tensive Care Unit was performed The coagulation profile requested by t he attending physician. that included platelet count, prothrombin time , partial thromboplastin time, thrombin time, protamine sulphate test, fibrinogen and euglobin lysis time, was analyzed, Fourteen patients t hat were receiving prophylactic subcutaneous heparin were excluded fro m further analysis. Of the 61 remaining patients, 23 had hemorrhagic m anifestations and 94.4% of these had multiple alterations in coagulati on parameters. Eighty one percent of patients had abnormal prothrombin time and 73% thrombocytopenia isolated alterations were infrequent an d consisted in thrombocytopenia (3.7%) and fibrinogen elevation (1.9%) . Fifty two percent of patients had shock and they had significantly l ower platelet counts and higher prothrombin and thrombin times than pa tients without hemodynamic disturbances Global mortality was 63.9%. No relation between coagulation disturbances and mortality was observed. Likewise, no differences in mortality between patients with or withou t shock was observed. It is concluded that coagulation is frequently d isturbed in patients with sepsis, even without clinical hemorrhagic sy mptoms, that these abnormalities are more marked in patients in shock and that 53% of these are consistent with intravascular coagulation.