INTRODUCTION: Impairment of fibrinolysis during @entity295 is associated with worse outcome. Early identification of this condition could be of interest. The aim of this study was to evaluate whether a modified point-of-care viscoelastic hemostatic assay can detect @entity295 -induced @entity73 and to correlate impaired fibrinolysis with morbidity and mortality. METHODS: This single center observational prospective pilot study was performed in an adult Intensive Care Unit (ICU) of a tertiary academic hospital. Forty consecutive @entity1 admitted to the ICU with severe @entity295 or @entity326 were included. Forty healthy individuals served as controls. We modified conventional kaolin activated thromboelastography (TEG) adding urokinase to improve assessment of fibrinolysis in real time (UK-TEG). TEG, UK-TEG, plasminogen activator inhibitor (PAI)-1, @entity557 ( @entity557 ), d-dimer, DIC scores and morbidity (rated with the SOFA score) were measured upon ICU admission. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) of mortality at ICU discharge. RESULTS: UK-TEG revealed a greater @entity73 in @entity295 @entity1 compared to healthy individuals confirmed by @entity2289 . @entity557 was not different between @entity295 @entity1 and healthy individuals. 18/40 @entity295 @entity1 had fibrinolysis impaired according to UK-TEG and showed higher SOFA score (8 (6-13) vs 5 (4-7), p = 0.03), higher mortality (39% vs 5%, p = 0.01) and greater markers of cellular damage ( @entity880 levels, LDH and @entity648 ). Mortality at ICU discharge was predicted by the degree of @entity73 measured by UK-TEG Ly30 (%) parameter (OR 0.95, 95% CI 0.93-0.98, p = 0.003). CONCLUSIONS: Sepsis-induced @entity73 detected at UK-TEG was associated with increased markers of cellular damage, morbidity and mortality.

Assessment of Fibrinolysis in Sepsis XXXX with Urokinase Modified Thromboelastography.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity295 :: ('MESH:D018805', 'Disease') :: ['sepsis'] @entity2289 :: ('5054', 'Gene') :: ['PAI-1'] @entity326 :: ('MESH:D012772', 'Disease') :: ['septic shock'] @entity73 :: ('MESH:D003072', 'Disease') :: ['impairment of fibrinolysis', 'fibrinolysis impairment'] @entity557 :: ('1361', 'Gene') :: ['TAFI', 'thrombin-activatable fibrinolysis inhibitor'] @entity648 :: ('MESH:D001663', 'Chemical') :: ['bilirubin'] @entity880 :: ('MESH:D019344', 'Chemical') :: ['lactate']
@entity1 :: (9606,Species) :: ['Patients']
