Emmanuel Schneck1, Omar Samara1, Christian Koch1, Andreas Hecker2, Winfried Padberg2, Christoph Lichtenstern3, Markus Alexander Weigand3, Florian Uhle4. 1. Department of Anesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Giessen, Germany. 2. Department of General and Thoracic Surgery, University Hospital of Giessen and Marburg, Giessen, Germany. 3. Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany. 4. Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany. Electronic address: florian.uhle@med.uni-heidelberg.de.
Abstract
BACKGROUND: Cell-free DNA (cfDNA) and extracellular RNA (exRNA) are both suspected to activate coagulation cascades in sepsis. Therefore, our study investigated the influence of plasmatic nucleic acids on coagulation in septic patients in comparison to patients after major abdominal surgery. MATERIALS AND METHODS: A total of 15 patients with sepsis, 10 postoperative patients, and 10 healthy volunteers were included in this longitudinal study. Blood was collected at sepsis onset and after surgery respectively, as well as after 24, 72 and 168 h. Levels of cfDNA and exRNA were measured by quantitative probe-based polymerase chain reaction. In addition, thromboelastography for coagulation as well as thromboaggregometry for platelet function was conducted. RESULTS: Both cfDNA and exRNA were elevated in patients with sepsis compared with postoperative patients and healthy volunteers. While higher exRNA levels correlated with a faster clotting time and more stable clots, cfDNA correlated with a shorter clotting time but also less fibrinolysis. In addition, higher cfDNA seems to be associated with kidney dysfunction as well as with general markers of cell damage (lactate dehydrogenase and lactate). CONCLUSIONS: Both nucleic acid species might be associated with different effects on coagulation during sepsis, with an overall procoagulatory influence. For this reason, individualized therapeutic approaches in patients suffering from coagulation-associated organ dysfunction might be feasible.
BACKGROUND: Cell-free DNA (cfDNA) and extracellular RNA (exRNA) are both suspected to activate coagulation cascades in sepsis. Therefore, our study investigated the influence of plasmatic nucleic acids on coagulation in septic patients in comparison to patients after major abdominal surgery. MATERIALS AND METHODS: A total of 15 patients with sepsis, 10 postoperative patients, and 10 healthy volunteers were included in this longitudinal study. Blood was collected at sepsis onset and after surgery respectively, as well as after 24, 72 and 168 h. Levels of cfDNA and exRNA were measured by quantitative probe-based polymerase chain reaction. In addition, thromboelastography for coagulation as well as thromboaggregometry for platelet function was conducted. RESULTS: Both cfDNA and exRNA were elevated in patients with sepsis compared with postoperative patients and healthy volunteers. While higher exRNA levels correlated with a faster clotting time and more stable clots, cfDNA correlated with a shorter clotting time but also less fibrinolysis. In addition, higher cfDNA seems to be associated with kidney dysfunction as well as with general markers of cell damage (lactate dehydrogenase and lactate). CONCLUSIONS: Both nucleic acid species might be associated with different effects on coagulation during sepsis, with an overall procoagulatory influence. For this reason, individualized therapeutic approaches in patients suffering from coagulation-associated organ dysfunction might be feasible.
Authors: Christopher Duplessis; Michael Gregory; Kenneth Frey; Matthew Bell; Luu Truong; Kevin Schully; James Lawler; Raymond J Langley; Stephen F Kingsmore; Christopher W Woods; Emanuel P Rivers; Anja K Jaehne; Eugenia B Quackenbush; Vance G Fowler; Ephraim L Tsalik; Danielle Clark Journal: J Intensive Care Date: 2018-11-13
Authors: Rabina Mainali; Manal Zabalawi; David Long; Nancy Buechler; Ellen Quillen; Chia-Chi Key; Xuewei Zhu; John S Parks; Cristina Furdui; Peter W Stacpoole; Jennifer Martinez; Charles E McCall; Matthew A Quinn Journal: Elife Date: 2021-02-22 Impact factor: 8.140