Decreased plasma activity of antithrombin or protein C is not due to consumption coagulopathy in septic patients with disseminated intravascular coagulation

We investigated whether depressed plasma antithrombin andprotein C activity , considered as a specific finding of disseminated intravascular coagulatio n (DIC), is due to consumption coagulopathy in septic patients with DIC. An analysis of hemostatic parameters was performed in 139 septic patients (68 with DIC and 71 without DIC). Plasma activity of antithrombin and protein C tended to be significantly decreased in septic patients with DIC but not in those without DIC (p < 0.001). However, when the septic patients were cl assified into three groups according to the albumin (or choline esterase) l evel, no significant differences in antithrombin activity or protein C acti vity were observed between the patients with and without DIC in any of the subgroups. Notably, neither the plasma activity of antithrombin nor protein C was decreased even in septic patients with DIC who had normal plasma lev els of albumin (or choline esterase). No significant correlation was observ ed between plasma levels of thrombin-antithrombin complex (TAT) and antithr ombin activity, or between plasma levels of TAT and protein C activity eith er in septic patients with DIC or without DIC. It is reasonable to conclude that the markedly reduced plasma activity of antithrombin and protein C is not due to consumption coagulopathy in septic patients with DIC.