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January 23/30, 2002

Use of Anticoagulants in Patients With Sepsis

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;287(4):448-449. doi:10.1001/jama.287.4.447

To the Editor: Dr Warren and colleagues1 reported that antithrombin III (AT) did not improve clinical outcomes in patients with severe sepsis or septic shock. These results are surprising in light of evidence of a procoagulant state during severe sepsis, which can be favorably affected by activated protein C (APC).2 Without a full understanding of the mechanisms of APC and AT activity, we are left with the empirical finding that a 4-day treatment of APC is helpful while 4 days of AT is not.