The Role of Plasma Proteases in Septic Shock

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Abstract
Gram-negative septicemia is a major cause of death and disability among hospitalized patients, with an incidence of several hundred thousand cases each year. If hypotension occurs in association with circulating bacteria or endotoxins, the mortality ranges from 40 to 60 percent,1 levels that have remained unchanged over the past 15 years. Septic shock is almost always associated with disseminated intravascular coagulation (DIC), a process in which microvascular thrombosis leads to the consumption of platelets and coagulation proteins and the stimulation of the fibrinolytic system,2 with resultant hemorrhage. Hemostatic abnormalities accompanied by endothelial changes are among the earliest manifestations of a . . .