Significance of heparin in the treatment of patients with sepsis / 中华危重病急救医学

ABSTRACT

The latest definition of sepsis (Sepsis-3) is the life-threatening organ dysfunction due to overreaction of immune system caused by infection. The situation can develop into multiple organ dysfunction syndromes (MODS). In the pathological process of pathogen invasion, a large number of inflammatory factors directly damage organ function, while dysfunction of coagulation system is also involved in this process. With the overreaction of inflammation, disseminated intravascular coagulation (DIC) occurred, which further exacerbated organ damage. As excessive inflammation and coagulation disorders are mutually reinforced, the clearance of pathogenic microorganisms and the control of inflammatory reactions cannot effectively improve the sepsis caused by MODS. As a clinically readily available anticoagulant, heparin is widely used in a variety of severe situations caused by DIC, thromboembolic disease and some invasive procedure for anticoagulant treatment. In recent years, domestic and foreign studies have found that heparin has a certain anti-inflammatory effect, which can reduce the incidence of DIC, improve sepsis patients with microcirculation and MODS, reduce 28-day mortality. However, there is controversy in its effectiveness and safety. Therefore, the application of heparin in the treatment of sepsis need to be further defined and discussed.