Effects of remazolam on sublagal microcirculation during anesthesia induction in patients undergoing off-pump coronary artery bypass grafting / 中华麻醉学杂志

Objective:To evaluate the effects of remazolam on sublingual microcirculation during anesthesia induction in the patients undergoing off-pump coronary artery bypass grafting under general anesthesia.Methods:Forty-two patients of both sexes, of American Society of Anesthesiologists Physical Status classification Ⅲ or IV, aged 45-75 yr, with body mass index of 18-30 kg/m 2, undergoing off-pump coronary artery bypass grafting under total intravenous anesthesia, were divided into 2 groups ( n=21 each) using a random number table method: propofol group (group P) and remazolam group (group R).Remazolam 0.15-0.35 mg/kg was intravenously infused in group R, and propofol 1.5-2.0 mg/kg was intravenously infused in group P, when patients lost consciousness and they did not response to shoulder tapping, the maintenance dose was adjusted as follows: remazolam 0.15-0.30 mg·kg -1·h -1 in group R and propofol 2.0-4.0 mg·kg -1·h -1 in group P. The BIS value was maintained at 45-55 during operation in the two groups.The proportion of perfused vessels for all vessels (PPV (all)), proportion of perfused small vessels (PPV (small)), perfused vessel density of all vessels (PVD (all)), and perfused small vessel density (PVD (small)) were recorded before induction (T 1), immediately after intubation (T 2) and 30 min after intubation (T 3).The cardiovascular events were recorded during anesthesia induction. Results:Compared with the baseline at T 1, PPV (all), PPV (small) and PVD (all) were significantly decreased at T 3 ( P<0.05), and no significant change was found in PPV (all), PPV (small), PVD (all) and PVD (small) at T 2 in group P ( P>0.05), and no significant change was found in PPV (all), PPV (small), PVD (all) and PVD (small) at T 2 and T 3 in group R ( P>0.05).Compared with group R, PPV (small) was significantly decreased at T 3 in group P ( P<0.01). Conclusions:Remazolam exerts less inhibitory effect on sublingual microcirculation than propofol during anesthesia induction in the patients undergoing off-pump coronary artery bypass grafting.

Efficacy of general anesthesia for percutaneous pulmonary valve implantation / 中华麻醉学杂志

Objective:To summarize the efficacy of general anesthesia for percutaneous pulmonary valve implantation (PPVI).Methods:The clinical data of 6 patients underwent PPVI under general anesthesia in Children′s Heart Center of Henan Provincial People′s Hospital from December 2017 to January 2020 were retrospectively analyzed.Systolic blood pressure, diastolic blood pressure, heart rate, central venous pressure, SpO 2 and regional cerebral oxygen saturation were recorded before anesthesia induction (T 1), after anesthesia induction (T 2), before beginning of surgery (T 3), before pulmonary valve implantation (T 4), during pulmonary valve implantation (T 5), immediately after pulmonary valve implantation (T 6) and when the patients left the operating room (T 7). Right ventricular systolic pressure, diastolic pressure, pulmonary artery systolic pressure and diastolic pressure were recorded at T 4 and T 6.The development of related complications during operation and the cardiac, liver and kidney functions before and after operation were recorded.The postoperative extubation time, intensive care unit stay time and hospital stay time were recorded. Results:Six patients (3 males, 3 females), aged (16±4) yr, weighing (41±12) kg, were analyzed.Compared with the value at T 1-4 and T 6, 7, systolic blood pressure, diastolic blood pressure, heart rate, regional cerebral oxygen saturation and SpO 2 were significantly decreased at T 5 ( P<0.05). Compared with the value at T 1-5, central venous pressure was significantly decreased at T 6, 7 ( P<0.05). Compared with the value at T 4, right ventricular diastolic pressure was significantly decreased, and pulmonary artery diastolic pressure was increased at T 6 ( P<0.05). No anesthesia- and surgery-related serious complications occurred among the patients.One patient was transferred to the ward after extubation in the operating room, and 5 patients were transferred to the intensive care unit after operation.All 6 patients were discharged successfully and entered the follow-up stage. Conclusion:General anesthesia provides better efficacy when used for PPVI, and hemodynamic monitoring of pulmonary circulation and systemic circulation should be strengthened during pulmonary valve implantation to maintain circulation stable.

Risk factors for postoperative acute kidney injury in patients undergoing off-pump coronary artery bypass grafting / 中华麻醉学杂志

Objective:To identify the risk factors for postoperative acute kidney injury (AKI) in patients undergoing off-pump coronary artery bypass grafting (OPCABG).Methods:The medical records of patients who underwent elective OPCABG from January 1, 2018 to December 31, 2020 from the Heart Center of Henan Provincial People′s Hospital, were retrospectively collected.The patient′s gender, age, body mass index, history of diabetes, history of hypertension, history of hyperlipidemia, history of chronic obstructive pulmonary disease, history of cerebrovascular disease, history of myocardial infarction, New York Heart Association classification of cardiac function, Killip classification, values of last left ventricular ejection fraction measured by transthoracic echocardiography before operation, glycosylated hemoglobin, glucose and serum creatinine, duration of operation, intraoperative fluid intake and output such as red blood cell infusion, crystal fluid, colloid fluid, autologous blood, blood loss and urine volume, intraoperative hypotension, perioperative maximal blood glucose difference (MGD) and serum creatinine concentrations within 48 h and 7 days were recorded.Postoperative AKI was defined according to the Kidney Disease Improving Global Outcomes criteria and the patients were divided into AKI group and non-AKI group according to whether AKI occurred after surgery.Logistic regression analysis was used to identify the risk factors for AKI after OPCABG.Results:A total of 1 203 patients were included in this study, and the incidence of AKI after OPCABG was 28.1%.Logistic regression analysis showed that body mass index, history of hypertension and perioperative MGD were risk factors for AKI after OPCABG ( P<0.05). Conclusion:Body mass index, history of hypertension and perioperative MGD are risk factors for AKI after OPCABG.

Risk factors for postoperative central nervous system complications developed in pediatric patients undergoing cardiac surgery under cardiopulmonary bypass: determination of rSO 2C by near-infrared spectroscopy / 中华麻醉学杂志

Objective:To identify the risk factors for postoperative central nervous system complications (CNSC) developed in pediatric patients undergoing cardiac surgery under cardiopulmonary bypass (CPB) through determining regional cerebral oxygen saturation (rSO 2C) by near-infrared spectroscopy. Methods:A total of 60 pediatric patients with congenital heart disease undergoing elective orthodontic correction surgery under CPB, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, of both sexes, aged 6-36 months, weighing 5-19 kg, in our hospital from July 2019 to January 2020 were collected.Intraoperative bilateral rSO 2C was monitored continuously by near-infrared spectroscopy.Blood samples were taken from the central vein at 10 min after induction of anesthesia, immediately after CPB, at the end of CPB, on admission to ICU, at 4 and 8 h after entering ICU and at 1, 2 and 3 days after surgery (T 0-8) for determination of the concentrations of serum S100β protein and neuron specific enolase (NSE). At 12 months after surgery, the Pediatric Cerebral Performance Category (PCPC) score was used to evaluate the prognosis of neurological function.The patients were divided into 2 groups according to whether CNSC occurred: CNSC group and non-CNSC group.Multivariate logistic regression analysis was used to identify the risk factors for development of postoperative CNSC in pediatric patients undergoing cardiac surgery under CPB. Results:Two patients were excluded from the study.Eighteen cases developed postoperative CNSC, and the incidence was 31.0%.Compared with group non-CNSC, the minimal rSO 2 was significantly decreased, the maximal difference between pulse oxygen saturation and rSO 2C (da-rSO 2C) was increased, duration of reduction in rSO 2>25% during CPB, duration of rSO 2C<40% during CPB and duration of da-rSO 2C>50% during CPB were prolonged, and concentrations of serum S100β protein and NSE were increased at T 2-T 8 in group CNSC ( P<0.05). The results of logistic regression analysis showed that prolonged duration of reduction in rSO 2C>25% during CPB, prolonged duration of rSO 2C<40% during CPB and prolonged duration of da-rSO 2C>50% during CPB were risk factors for development of postoperative CNSC. Conclusion:Prolonged duration of reduction in rSO 2C>25% during CPB, prolonged duration of rSO 2C<40% during CPB and prolonged duration of da-rSO 2C>50% during CPB are the risk factors for postoperative CNCS developed.

Effects of thoracic paravertebral block on graft patency in off-pump coronary artery bypass grafting / 中华麻醉学杂志

Objective:To evaluate the effects of thoracic paravertebral block (TPVB) on graft patency in off-pump coronary artery bypass grafting.Methods:Fifty American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients, aged 60-75 yr, weighing 50-80 kg, undergoing elective off-pump coronary artery bypass grafting under combined intravenous-inhalational anesthesia, were divided into 2 groups using a random number table method: control group (group C, n=30) and TPVB group (group T, n=20). In group T, TPVB was performed at T 4, 5 interspace under the guidance of ultrasound, a test dose of 1% lidocaine 5 ml was injected on both sides, and 2 min later 0.375% ropivacaine 15 ml was injected.According to the anatomy of coronary artery, the graft was divided into 4 parts: left internal thoracic artery-anterior descending branch (arterial graft), the middle branch or the first diagonal branch, blunt marginal branche, and right posterior descending branch or left ventricular posterior branch.The blood flow was measured and pulsatility index was calculated after graft transplantation.Central venous pressure, mean pulmonary artery pressure, cardiac output, systemic resistance index and pulmonary resistance index were recorded immediately after placement of floating catheter (T 1), immediately after sawing sternum (T 2), immediately after anastomosis of all grafts (T 3) and 5 min before leaving the room (T 4). The intraoperative cardiovascular adverse events and consumption of sufentanil were recorded. Results:Compared with group G, central venous pressure, systemic resistance index and pulmonary resistance index were significantly decreased, cardiac output were increased, the incidence of intraoperative tachycardia was decreased, the incidence of hypotension was increased, the consumption of sufentanil was reduced, the flow of left internal thoracic artery-anterior descending branch was increased, and the pulsatility index was decreased at T 3 and T 4 in group T ( P<0.05). Conclusion:TPVB can improve the patency of left internal thoracic artery-anterior descending branch in off-pump coronary artery bypass grafting.

The application of percutaneous renal oxygen saturation and abdominal local oxygen saturation in infants undergoing cardiac surgery / 中华实用儿科临床杂志

Objective:To investigate the changes and their clinical values of renal oxygen saturation(RrSO 2) and abdominal local oxygen saturation(A-rSO 2) in infants who underwent cardiac surgery. Methods:Thirty children with atrial septal defect or ventricular septal defect underwent cardiopulmonary bypass (CPB) in Henan People′s Hospital from April to August 2019 were randomly selected.There were 15 males and 15 females, aged 2-13 months, weighted 4.5-10.0 kg and American Society of Anesthesiologists(ASA) grade Ⅰ-Ⅲ.The probe of near-infrared spectroscopy(NIRS)was fixed at the body surface of the right kidney and 1 cm below the umbilicus.RrSO 2 and A-rSO 2 were continuously monitored during operation.The changes of parameters, including RrSO 2, A-rSO 2, mean arte-rial pressure(MAP), and nose temperature were recorded after anesthesia induction (T 0), cardiopulmonary bypass (T 1), 5 minutes after aortic blockade (T 2), the lowest temperature (T 3), 5 minutes after aortic opening (T 4), and 5 minutes after stopping cardiopulmonary bypass (T 5). CPB time, ascending aorta occlusion time and operation time were recorded as well.Meanwhile, perioperative complications such as acute renal injury (AKI) and gastrointestinal dysfunction were recorded.Relevant information, including the time of first eating after operation was recorded. Results:Totally, 30 children were enrolled in this study.The basic values of RrSO 2 and A-rSO 2 were (70.00±7.50)% and (70.70±11.29)%, respectively.Compared with T 0, the RrSO 2 and A-rSO 2 of patients decreased at T 1, gradually increased at T 2, T 3 and T 4, and returned to T 0 at T 5.There was no significant difference in RrSO 2 and A-rSO 2 at each observation point. Pearson correlation analysis displayed that there was a positive correlation between A-rSO 2 and RrSO 2 ( r=0.806, P<0.01). RrSO 2 and A-rSO 2 were positively correlated with MAP ( r=0.565, 0.605, all P<0.05), and negatively correlated with the nasopharynx temperature ( r=-0.365, -0.331; all P<0.05). Among them, 3 children(10%) suffered from AKI after operation.Compared with T 0, RrSO 2 values at T 1, T 2, T 3 and T 4 decreased significantly ( P<0.05). Postoperative gastrointestinal hysteresis occurred in 6 children(20%). The A-rSO 2 value in T 0-T 5 of children with gastrointestinal hysteresis was significantly lower than that of children without gastrointestinal hysteresis ( P<0.05). Conclusions:As a new noninvasive monitoring method of renal and intestinal function, NIRS has certain clinical guiding value in perioperative period of infantile congenital heart disease.

Risk factors for postoperative hyperlactatemia in patients with type A aortic dissection / 中华麻醉学杂志

Objective@#To identify the risk factors for postoperative hyperlactatemia in the patients with type A aortic dissection.@*Methods@#Medical records of patients with type A aortic dissection who underwent cardiovascular surgery from January 2012 to October 2017 were retrospectively collected.The patients were divided into hyperlactatemia group and non-hyperlactatemia group according to the occurrence of hyperlactatemia (blood lactic acid ≥6 mmol/L) at 8 h after surgery.The variables of which P values were less than 0.05 in univariate analysis would enter the logistic regression analysis to stratify the risk factors for postoperative hyperlactatemia in this type of patients.@*Results@#A total of 295 patients were included, of which 80 cases developed postoperative hyperlactatemia, and the incidence was 27.1%.Logistic regression analysis showed that preoperative acute pericardial tamponade, intraoperative deep hypothermic circulatory arrest time>35 min) and massive transfusion of blood (>1 000 ml) within 8 h after operation were independent risk factors for postoperative hyperlactatemia in the patients with type A aortic dissection.@*Conclusion@#Preoperative acute pericardial tamponade, intraoperative deep hypothermic circulatory arrest time>35 min and massive transfusion of blood (>1 000 ml) within 8 h after operation are independent risk factors for postoperative hyperlactatemia in the patients with type A aortic dissection.

Risk factors for postoperative hyperlactatemia in patients with type A aortic dissection / 中华麻醉学杂志

Objective To identify the risk factors for postoperative hyperlactatemia in the patients with type A aortic dissection.Methods Medical records of patients with type A aortic dissection who underwent cardiovascular surgery from January 2012 to October 2017 were retrospectively collected.The patients were divided into hyperlactatemia group and non-hyperlactatemia group according to the occurrence of hyperlactatemia (blood lactic acid ≥6 mmol/L) at 8 h after surgery.The variables of which P values were less than 0.05 in univariate analysis would enter the logistic regression analysis to stratify the risk factors for postoperative hyperlactatemia in this type of patients.Results A total of 295 patients were included,of which 80 cases developed postoperative hyperlactatemia,and the incidence was 27.1％.Logistic regression analysis showed that preoperative acute pericardial tamponade,intraoperative deep hypothermic circulatory arrest time＞35 min) and massive transfusion of blood (＞ 1 000 ml) within 8 h after operation were independent risk factors for postoperative hyperlactatemia in the patients with type A aortic dissection.Conclusion Preoperative acute pericardial tamponade,intmoperative deep hypothermic circulatory arrest time＞35min and massive transfusion of blood (＞ 1 000 ml) within 8 h after operation are independent risk factors for postoperative hyperlactatemia in the patients with type A aortic dissection.

Analysis of risk factors for perioperative hyperbilirubinemia in Stanford type A aortic dissection / 中华胸心血管外科杂志

Objective To analyze the independent risk factors and complications for perioperative hyperbilirubinemia in Stanford type A aortic dissection undergoing operation and investigate the management strategy of perioperative hyperbilirubi-nemia. Methods Between January 2013 and January 2018 from the department of great vessel surgery of heart centre of,290 cases of patients with Stanford type A aortic dissection undergoing operation were collected consecutively,male 210 cases,fe-male 80 cases. The related data and perioperative peak hyperbilirubinemia were recorded. According to the perioperative peak hyperbilirubinemia,patients were divided into 2 groups:≥51. 3 μmol/ L group and < 51. 3 μmol/ L group. Univariate and lo-gistic regression analysis were used to identify the independent risk factors. The perioperative complications were also recorded. Results Preoperative total bilirubin ≥ 17. 1 μmol/ L(OR = 2. 105,95％ CI: 1. 153 - 3. 125,P = 0. 016),cardiopulmonary bypass time > 3. 5 h(OR = 1. 103,95％ CI: 1. 316 - 6. 151,P = 0. 031),a large number of hemolysis(OR = 1. 503,95％CI: 1. 506 - 6. 651,P = 0. 029),the input amount of 24 h allogeneic red blood cell > 2000 ml(OR = 1. 381,95％ CI:0. 956 - 2. 552,P = 0. 036)were the independent risk factors for perioperative hyperbilirubinemia. The incidence rate of post-operative acute hepatic failure(2. 5％ vs. 0,P = 0. 021)and artificial liver therapy(2. 5％ vs. 0,P = 0. 021)in≥51. 3μmol/ L group were significantly increased. The incidence rate of postoperative acute lung injury(37. 5％ vs. 25. 2％,P =0. 039)and acute kidney injury(38. 7％ vs. 19. 5％,P = 0. 035)in 51. 3 μmol/ L group were also significantly increased. The duration of mechanical ventilation[(4. 1 ± 1. 6)days vs. (2. 8 ± 1. 3)days,P < 0. 05]and ICU stay time[(5. 1 ± 2. 3)days vs. (3. 9 ± 1. 8)days,P = 0. 035]and hospitalization time[( 19. 3 ± 3. 1)days vs. ( 17. 3 ± 2. 5)days,P = 0. 035]were sig-nificantly prolonged. Temporary nerve dysfunction(52. 5％ vs. 32. 6％,P = 0. 002)and in-hospital mortality( 17. 5％ vs. 8. 1％,P = 0. 037)were significantly increased. Conclusion Preoperative total bilirubin ≥ 17. 1 μmol/ L,cardiopulmonary bypass time > 3. 5 h,a large number of hemolysis,the input amount of 24 h allogeneic red blood cell > 2000 ml were the in-dependent risk factors for perioperative hyperbilirubinemia in Stanford type A aortic dissection. The perioperative complications in≥51. 3 μmol/ L group were significantly increased. Therefore,more attention should be paid to the independent risk factors for perioperative hyperbilirubinemia in Stanford type A aortic dissection,hyperbilirubinemia and its clearance should be moni-tored more actively and dynamically,the cause should be found more precisely,the treatment be more comprehensive to achieve to control the level of bilirubinemia and improve the prognosis.

The Blood-saving Effect of Autologous Platelet-rich Plasma Back-transfusion in Patients With Stanford Type A Aortic Dissection Surgery / 中国循环杂志

Objective: To explore the blood-saving effect of autologous platelet-rich plasma (PRP) back-transfusion in patients with Stanford type A aortic dissection surgery. Methods: A total of 59 consecutive patients who received Stanford type A aortic dissection surgery in our hospital from 2013-01 to 2015-10 were studied. The patients were at the age of (50±6) years with mean body weighting at (80±12) kg and were randomly divided into 2 groups: Traditional (T) group,n=31 and Autologous PRP back-transfusion (P) group,n=28. Blood levels of Hb, platelet counts, PT, APTT were measured at pre-induction of anesthesia (T1), before CPB (T2), prior ifnishing of CPB (T3) and at 1 h (T4), 24 h (T5), 48 h (T6) after the operation. The in-operative, 48 h post-operative volumes of allogeneic blood transfusion and the volume of chest tube drainage at 48h after operation were recorded; the complication occurrence at peri-operative period was recorded. Results: In P group, whole blood processing volume was (1269±197) ml, PRP volume was (753±78) ml, PRP separation time was (35±9) min and the separated platelets were about (22±3)% of total platelet counts. Compared with T group, P group had decreased Hb at T2 (131.0±15.0) g/L vs (101.0±10.0) g/L, decreased platelet counts at T3 (115.0±51.0)×109 /L vs (83.0±23.0)×109/L, while increased platelet counts at T4 (103.0±25.0)×109/L vs (151.0±27.0)×109/L, T5 (105.0±25.0)×109 /L vs (147.0±39.0)×109/L and T6 (101.0±26.0) ×109/L vs (149.0±35.0)×109/L, allP<0.05; P group presented reduced PT at T4 (17.6±2.1) s vs (14.1±1.1) s and T5 (17.6±2.7) s vs (13.5±0.8) s, allP<0.05. The in-operative transfusions of platelet, plasma, cold precipitation and post-operative transfusions of red blood cells, platelets, plasma, cold precipitation and the volume of chest tube drainage at 48h after operation were less in P group,P<0.05. Compared with T group, P group had the lower rates of acute post-operative lung injury (32.1% vs 19.4%), shorter mechanical ventilation time (69.1±5.9) h vs (43.1±1.5) h and ICU staying time (8.1±2.8) d vs (5.3±1.1) d, allP<0.05. Conclusion: Autologous PRP back-transfusion could reduce the post-operative bleeding and allogeneic blood transfusion for Stanford A aortic dissection surgery, it has obvious blood-saving effect.

Blood-saving effect of tranexamic acid in patients undergoing Stanford type A aortic dissection surgery / 中华麻醉学杂志

Objective To investigate the blood-saving effect of tranexamic acid in patients undergoing Stanford type A aortic dissection surgery.Methods Fifty-six patients of both sexes with acute Stanford type A aortic dissection, aged 34-58 yr, weighing 62-84 kg, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ , with their left ventricular ejection fraction ＞ 40％, undergoing emergency surgery, were randomly divided into 2 groups: control group (group C, n=26) and tranexamic acid group (group TA, n=30).Tranexamic acid was infused as a bolus of 10 mg/kg over 30 min before skin incision followed by an infusion of 10 mg · kg-1 · h-1 throughout the surgery in group TA.The equal volume of normal saline was given instead in group C.The total volume of drainage at 24 h after operation, the postoperative requirement of allogeneic red blood cells, fresh frozen plasma and platelets, and re-thoracotomy for bleeding were recorded.The postoperative mechanical ventilation time, duration of intensive care unit stay, and complications after operation were also recorded.Results Compared with group C, the total volume of drainage at 24 h after operation, and the requirement of allogeneic red blood cells, fresh frozen plasma and platelets were significantly reduced, the incidence of rethoracotomy for bleeding was decreased, the postoperative mechanical ventilation time, and duration of intensive care unit stay were shortened, and the incidence of postoperative acute lung injury and transient neurological dysfunction were decreased in group TA.Conclusion Tranexamic acid has blood-saving effect and can reduce postoperative bleeding and allogeneic blood transfusion in patients undergoing Stanford type A aortic dissection surgery.

The effect of anticoagulant therapy on coagulation and inflammation markers in sepsis patients and its significance / 中华危重病急救医学

ObjectiveTo study the effect of anticoagulant therapy with low molecular weight heparin (LMWH) on coagulation and inflammation markers in sepsis patients.Methods A prospective randomized controlled trial was conducted. Sixty sepsis patients admitted to intensive care unit (ICU) of Zhengzhou University People's Hospital from March 2012 to May 2014 were divided into control group and observation group, with 30 cases in each group. The observations were begun as soon as the diagnosis of sepsis was established, and the observation time was 7 days. All sepsis patients were treated according to the 2008 international sepsis treatment guidelines. Every patient in the observation group was subcutaneously injected with LMWH 0.6 mL on the first day of ICU admission, twice a day for 7 days. The blood from peripheral vein was collected at 1, 3, 5, 7 days of treatment, and CD62p, interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were determined by enzyme linked immunosorbent assay (ELISA), D-dimmer was determined by immunoturbidimetry, acute physiology and chronic health evaluationⅡ (APACHEⅡ) score was recorded, and incidence of multiple organ dysfunction syndrome (MODS) was also evaluated.Results There were no significant differences in values of all parameters, including CD62p, D-dimmer, IL-6, TNF-α, and APACHEⅡ score at 1 day of treatment. The values of all parameters in observation group were gradually decreased. CD62p at 3 days of treatment and D-dimmer, IL-6, TNF-α, and APACHEⅡ score at 5 days of treatment were significantly lower than those at 1 day of treatment. The values in the control group were decreased at first and then increased, as D-dimmer, IL-6 and TNF-α were significantly higher on the 5th day than those at 1 day of treatment. Compared with control group, CD62p, D-dimmer, IL-6, TNF-α and APACHEⅡ score on the 7th day of treatment were significantly lowered in observation group [CD62 (μg/L): 22.64±2.88 vs. 31.52±2.81, D-dimmer (g/L): 1.32±0.46 vs. 4.79±0.82, IL-6 (ng/L): 5.84±1.87 vs. 49.64±3.12, TNF-α (ng/L): 21.04±3.15 vs. 130.58±6.26, APACHEⅡ score: 9.71±2.02 vs. 14.17±2.38, allP< 0.05]. Correlation analysis showed that in observation group, CD62p, D-dimmer, IL-6, and TNF-α were positively correlated with APACHEⅡ score (r value was 0.907, 0.868, 0.880, 0.693, respectively, all P=0.000). The incidence of MODS in observation group was significantly lower than that in the control group [26.7% (8/30) vs. 46.7% (14/30),χ2=3.943,P= 0.028].Conclusions LMWH, which was given early in sepsis, can significantly down-regulate the expression of CD62p, D-dimmer, IL-6 and TNF-α, and reduce the incidence of MODS. Some indicators regarding coagulation and inflammation can be used as supplementary indicators to severity scores, and it may be able to improve the accuracy of scoring systems for sepsis.