Unraveling Severe Sepsis

Abstract
In this issue of THE JOURNAL, Abraham and colleagues1 report the results of an international, multicenter randomized controlled trial (optimized phase 3 tifacogin in multicenter international sepsis trial [OPTIMIST]) that compared a 96-hour infusion of recombinant tissue factor pathway inhibitor (TFPI) with placebo in 1754 critically ill patients with sepsis and mild coagulopathy (international normalized ratio [INR] ≥1.2). Tissue factor pathway inhibitor, a naturally occurring anticoagulant, modulated the coagulation cascade but did not impact the mortality rate.