Pathogenesis of the Altered Vascular Hemostasis Properties in Sepsis: In vivo Studies

Systemic infection is almost invariably associated with changes in the hemostatic mechanism, either at the clinical or subclinical level (Levi 1993). Patients with sepsis demonstrate evidence for activation of the common pathway of the coagulation system, as well as signs of stimulation of the intrinsic and the extrinsic pathway of the coagulation cascade, two separate routes that traditionally were considered to contribute to the development of disseminated intravascular coagulation (DIC)(Colman 1989, Levi et al., 1993, Ten Cate et al., 1993). Concurrently, in these patients the fibrinolytic system shows signs of early activation and subsequent inhibition. The net result of this disbalance in the hemostatic mechanism is widespread deposition of microthrombi in the vasculature of patients with generalized infection. © 1996 by Taylor & Francis Group, LLC.