Introduction: Two endothelium derived molecules integral to coagulation and fibrinolysis are tissue factor (TF) a procoagulant factor released from tissue after endothelial damage, and plasminogen activator inhibitor type 1 (PAI-1) an anti-fibrinolytic protein which prevents tissue plasminogen activator (TPA) induced fibrinolysis. Endotoxin increases TF and PAI in vitro and in vivo. Because persistent multiple organ failure (PMOF) is associated with continued inflammation, we hypothesized that PMOF would also be associated with increased TF and PAI-1.

Methods: TF, PAI-1, and PAI-1 activity were measured from plasma in 105 patients on days 1 and 3 of sepsis and 14 control critically ill children without sepsis. Patients with PMOF (3 or greater organ failure on day 3, n = 25) were compared to children with resolved MOF (RMOF defined as 3 or greater organ failure on day 1 or 2 but less than 3 organ failure by day 3, n = 36), and children without MOF (NMOF defined as less than 3 organ failure for the first three days of sepsis, n = 44). Values mean +/- SEM. Statistics Two factor ANOVA with Tukey's test

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