Abstract
In recent times, patients with sepsis accompanied by disseminated intravascular coagulation （septic DIC ）, have a significantly high mortality rate. Many clinical trials have failed to prove the efficacy of antithrombotic therapy for septic DIC. This is partly because antithrombotic therapy could impair the host defense against bacterial invasion. It is difficult to distinguish physiological thrombosis formation from pathological ones in septic patients. This is due to a difficulty to discern when to begin antithrombotic therapy for pathological thrombosis. In addition, we do not have any guidelines for the adequate choice and duration of therapy.
Furthermore, several reports revealed that treatment strategy based on an early goal achievement for septic patients is similar in outcome with conventional therapy. Improvement of circulation is essential for DIC treatment because impaired circulation enhances tissue factor expression on the endothelial surface. However, hemodynamic parameters such as arterial blood pressure and central venous pressure are not enough for adequate management and follow-up.
Novel therapeutic regimens are needed in both antithrombotic and circulatory management.
