It has been noted that abnormalities of coagulation accompany SIRS and sepsis. In many patients there appears to be a disseminated intravascular coagulation and sepsis is one of the main causes of elevations in D-dimers and in fibrinogen degradation products.
Children with meningococcal septicaemia often develop pupura, this is termed purpura fulminans. In these children low levels of activated protein C are associated with a poor prognosis. A recombinant human activated protein C has been developed and has been used in clinical trials. It has been shown to be beneficial in patients with sepsis.
Human recombinant activated protein C has been shown to reduce mortality in
adults with sepsis in a randomised controlled trial. [DLJ+03]
The downside to administrating activated protein C is that it is a natural anticoagulant and its use is associated with a low but significant risk of serious bleeding. Studies in the United States suggest that the cost of using recombinant activated protein C is about 160 thousand dollars per life saved.