CHANGES IN THE HEMOSTATIC SYSTEM IN CHILDREN WITH SEPSIS AND SEVERE SEPSIS

Authors

  • Ya. M. Pidhirnyy
  • O. V. Filyk

Keywords:

children, hemostasis, cytokines, sepsis, severe sepsis

Abstract

This article describes the dynamics of the hemostatic system and the levels of proinflammatory and antiinflammatory cytokines in children with sepsis. We examined 33 children aged 3 to 11 years with sepsis. The patients were divided into two groups: the first one included children with sepsis, that during the first three days had a positive clinical and paraclinical dynamics of the state. The second one included patients who developed severe sepsis within the next three days. To investigate the hemostatic profile we determined: prothrombin index, thrombin index, activated partial thromboplastin time, international normalized ratio, soluble fibrin-monomer complexes, antithrombin III, levels of D-dimer’s, time of XIIadependent fibrinolysis, platelet count. The levels of TNF-α, IL-6, IL-2 was determined by ELISA. The dynamics of hemostatic parameters, cytokine levels and the level of organ dysfunction on a scale P-MODS analyzed at 1 and 3 days of treatment. We studied the relationship between indicators of hemostasis and cytokine levels, using correlation analysis. Patients of the first group observed a significant decrease in time ХIIa-dependent fibrinolysis and a decrease in D-dimers’ level in the third day of treatment with simultaneous decrease in the level of multiple organ dysfunction on a scale P-MODS. The patients of the second group on the third day of treatment decreased the level of thrombin index, total fibrinogen, platelet count, increased levels of soluble fibrin-monomer complexes that can be described as a stage hypercoagulable of disseminated intravascular coagulation syndrome with a tendency to hypocoagulation. Increase of level TNF-α in patients with sepsis is a negative prognostic sign and is accompanied by the increase of the level of multiple organ dysfunction syndrome and depletion haemostatic potential.

References

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Published

2023-03-08

How to Cite

Підгірний, Я. М., & Філик, О. В. (2023). CHANGES IN THE HEMOSTATIC SYSTEM IN CHILDREN WITH SEPSIS AND SEVERE SEPSIS. Clinical Anesthesiology and Intensive Care, (2), 38–47. Retrieved from http://journals.ieu.kiev.ua/index.php/caic/article/view/121

Issue

Section

PROBLEMS OF ANESTHESIOLOGY AND INTENSIVE CARE