Figure 2.

The coagulation, fibrinolytic, and natural anticoagulant systems. Both the extrinsic pathway and contact pathway are activated in sepsis. Tissue factor, expressed on the monocytes, endothelial cells, and extracellular vesicles triggers the extrinsic pathway, while the phosphatidylserine residue present in various cell membranes initiates the contact pathway of coagulation. Antithrombin/heparin, thrombomodulin/protein C, and tissue factor pathway inhibitor (TFPI) are the three major physiologic anticoagulant systems. FDP: fibrin/fibrinogen degradation products.