Why anticoagulant studies on sepsis fail frequently-start with SCARLET  

作　　者：Jian-Ying Guo Hong-Yuan Lin 

机构地区：[1]Department of the Intensive Care Unit,The Fourth Medical Center of General Hospital of PLA,100048,Beijing,China

出　　处：《Chinese Journal of Traumatology》2023年第5期297-302,共6页中华创伤杂志（英文版）

摘　　要：The Sepsis Coagulopathy Asahi Recombinant LE Thrombomodulin(SCARLET)trial has many defects,and thus cannot be the terminator of recombinant thrombomodulin(rTM).On the contrary,it provides sufficient evidence for further research.Based on analysis focusing on the failure of SCARLET and several previous anticoagulant studies,it is most important for new studies to grasp the following two points:(1)The enrolled cases should have sufficient disease severity and a clear standard for disseminated intravascular coagulation;(2)Heparin should not be used in combination with the investigated drugs.Multiple post-hoc analyses show that no combination of heparin will not increase the risk of thromboembolism.In fact,the combination of heparin can mask the true efficacy of the investigated drug.Due to the complexity of sepsis treatment and the limitations of clinical studies,the results of all treatment studies should be repeatedly verified,rather than be determined at one stroke.Some research conclusions contrary to disease physiology,pharmacology and clinical practice may be deceptive,and should be cautious rather than be simply accepted.On the other hand,the dissenting voices in the"consensus"scene are often well discussed by the authors and should be highly valued.

关 键 词：SEPSIS Disseminated intravascular coagulation COAGULOPATHY ANTI-COAGULATION 

分 类 号：R515.3[医药卫生—内科学]