@article {Collins:October 2006:0007-1048:220,
	author = "Collins, Peter W.",
	author = "Macchiavello, Luis I.",
	author = "Lewis, Sarah J.",
	author = "Macartney, Nichola J.",
	author = "Saayman, Anton G.",
	author = "Luddington, Roger",
	author = "Baglin, Trevor",
	author = "Findlay, George P.",
	title = "Global tests of haemostasis in critically ill patients with severe sepsis syndrome compared to controls",
	journal = "British Journal of Haematology",
	volume = "135",
	year = "October 2006",
	abstract = "Summary <P></P>Haemostatic changes in septic patients are complex, with both procoagulant and anticoagulant changes. Thirty-eight patients with severe sepsis and 32 controls were investigated by coagulation screens, individual factor assays, calibrated automated thrombography (CAT), whole blood low-dose-tissue factor activated (LD-TFA) Rotem and LD-TFA waveform analysis. Thirty-six of 38 patients had an abnormal coagulation screen. The mean levels of factors II, V (<I>P</I>&#8201;&#60;&#8201;0&#183;05), VII, X, XI and XII, antithrombin and protein C (<I>P</I>&#8201;&#60;&#8201;0&#183;01) was decreased in sepsis compared with controls. The mean factor VIII and fibrinogen level (<I>P</I>&#8201;&#60;&#8201;0&#183;001) was increased. CAT in platelet rich and poor plasma showed a prolonged lag time (<I>P</I>&#8201;&#60;&#8201;0&#183;02), decreased peak thrombin (<I>P</I>&#8201;&#60;&#8201;0&#183;02) and delayed time to peak thrombin (<I>P</I>&#8201;&#60;&#8201;0&#183;001) in sepsis patients, however, the endogenous thrombin potential was equivalent in sepsis and controls. In LD-TFA Rotem, septic patients had delayed clot times (<I>P</I>&#8201;=&#8201;0&#183;04) but an increased maximum velocity of clot formation (<I>P</I>&#8201;&#60;&#8201;0&#183;01) and area under the clot elasticity curve (<I>P</I>&#8201;&#60;&#8201;0&#183;01). LD-TFA waveform analysis showed a delayed onset time but an increased rate of clot formation (<I>P</I>&#8201;&#60;&#8201;0&#183;005). In conclusion, global tests of haemostasis suggest that in this patient group, activation of haemostasis is delayed but once initiated thrombin generation and clot formation are normal or enhanced.",
	pages = "220-227(8)",
	url = "http://www.ingentaconnect.com/content/bsc/bjh/2006/00000135/00000002/art00013"
	doi = "doi:10.1111/j.1365-2141.2006.06281.x"
}