PŘEHLEDOVÉ ČLÁNKY Sepsou asociovaná diseminovaná intravaskulárna koagulácia – stály problém súčasnosti | E17 / Vnitř Lék. 2023;69(8):E10-E18 / VNITŘNÍ LÉKAŘSTVÍ www.casopisvnitrnilekarstvi.cz Antifibrinolytiká Keďže supresia endogénnej fibrinolýzy je najčastejšou zmenou fibrinolýzy pri DIC vyvolanom sepsou, použitie antifibrinolytík (kyselina tranexamová) sa u týchto pacientov vo všeobecnosti neodporúča (42, 60). Záver Diseminovaná intravaskulárna koagulácia je život ohrozujúca komplikácia charakterizovaná systémovou aktiváciou koagulácie vznikajúca ako častá komplikácia sepsy. Je spojená s potlačením fibrinolýzy, ktorá môže ľahko progredovať do dysfunkcie a zlyhania viacerých orgánov, čo vyvoláva potrebu včasnej diagnostiky a intervencie. Na tento účel bolo navrhnutých niekoľko súborov kritérií, z ktorých v súčasnosti dominuje sekvenčná diagnostika pomocou kritérií SIC a manifestnej DIC. Táto stratégia umožňuje posúdenie závažnosti stavu každého pacienta, od ktorého sa odvíja charakter liečby. Tá je však napriek pokrokom vo výskume patofyziológie rozporuplná a vyžaduje ďalšie štúdie. LITERATÚRA 1. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus definitions for sepsis and septic shock (sepsis-3). JAMA. 2016;315:801-810. 2. The Brussels Sepsis Resolution. Global Sepsis Alliance, Brussels, March 20th, 2018. 3. Howell MD, Davis AM. Management of sepsis and septic shock. JAMA.2017;317:847-8. 4. Engelmann B, Massberg S. Thrombosis as an intravascular effector of innate immunity. Nat Rev Immunol. 2013;13(01):34-45. 5. Martinod K, Deppermann C. Immunothrombosis and thromboinflammation in host defense and disease. Platelets. 2021;32(3):314-324. 6. Taylor FB, Toh CH, Hoots WK, Wada H, Levi M, et al. Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. 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