ABSTRACT
The objective of this study was to investigate the influence of sepsis on protein C [PC] activity and soluble thrombomodulin [s-TM] in relation to tumor necrosis factor-alpha [TNF-alpha]. Also, to orrelate these parameters with the SOFA score and serum lactate concentration as predictors of morbidity and mortality in septic patients. Thirty two adult patients [17 with sepsis and 15 with severe sepsis] in the intensive care unit [ICU], as well as 10 healthy age- and sex- matched controls were accrued to the study. The results showed that the baseline values of PC activity were significantly lower in both groups of septic patients compared to the controls, whereas, the serum levels of s-TM, TNF-alpha and lactate were significantly higher in the former compared to the latter. Moreover, survivors in both patient groups had higher PC activity and lower serum levels of s-TM, TNF-alpha and lactate compared to non survivors, both on day [1] and day [3] of ICU admission with variable statistical significance reflecting the heterogeneity of sepsis and the well-known individual patient variation. In addition, day [3] samples showed significant increase in PC activity and reduction in serum levels of s-TM, TNF-alpha, lactate and SOFA scores in survivors and the reverse in non survivors compared to baseline levels. Also, baseline PC activity was correlated negatively with SOFA score but not with serum TNF-alpha in both groups of septic patients. It was also negatively correlated with serum TM and lactate in sepsis but not in severe sepsis