Thromb Haemost 2007; 98(03): 579-586
DOI: 10.1160/TH07-01-0006
Review Article
Schattauer GmbH

The role of heparin and allied compounds in the treatment of sepsis

Alexander D. Cornet
1   Department of Intensive Care, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
,
Ellen G. M. Smit
1   Department of Intensive Care, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
,
Albertus Beishuizen
1   Department of Intensive Care, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
,
A. B. Johan Groeneveld
1   Department of Intensive Care, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Received 04. Januar 2007

Accepted after major revision: 17. Mai 2007

Publikationsdatum:
28. November 2017 (online)

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Summary

The crosstalk between coagulation and inflammation and the propensity for microthromboembolic disease during sepsis calls for anticoagulant measures to prevent tissue hypoxygenation and to attenuate organ damage and dysfunction. Only one anticoagulant, recombinant human activated protein C (aPC, drotrecogin-α) has a proven survival benefit when used as an adjunctive therapy for human sepsis, partly because of its anti-inflammatory effect. However, heparin (-like compounds) may exert similar beneficial anti-inflammatory actions as aPC, in spite of the relatively narrow therapeutic window for anticoagulation. This narrative review is based on a Medline search of relevant basic and clinical studies published in English and discusses the potential role of heparin in modulating inflammatory responses in the treatment of animal models and human sepsis and its harmful sequelae. In any case, the results of a metaanalysis based on animal data suggest a potentially life-saving effect of heparin (-like compounds) in the treatment of sepsis.Therefore, a prospective randomized clinical trial is called upon to study effects in human sepsis.