Studies of components of the coagulation systems in normal individuals and septic shock patients.

Components of the coagulation system were determined in plasma samples from normal individuals and septic shock patients. The parameters measured included Hageman factor (HF), prekallikrein (PKK), high molecular weight kininogen (HMwK), antithrombin III (AT III), fibrinogen (Fg) and fibrin(ogen) degradation products (FDP's). The combined effects of factors II, VII & X were estimated using Normotest (NT). Plasma levels of HF, PKK, and HMwK and both immunochemical levels and functional activities of AT III were significantly lower in the septic shock patients. NT values were also significantly reduced. Fibrinogen levels varied from very low to very high indicating both Fg consumption and acute-phase synthesis. Elevated FDP levels were seen during septic shock, but no difference between survivors and fatal cases was found. Prekallikrein levels and functional AT III activities were significantly higher in the samples from patients who recovered following septic shock than in the samples from subjects who died. During treatment all the parameters gradually returned toward normal in the survivors, whereas continuous low values for HF, AT III, PKK, and NT were observed in the fatal cases.