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Promising therapeutic interventions were initially focused on three main components: plasma tissue factor (TF), thrombin and protein C The immune system and coagulation pathways interact through a complex array of cross-signaling, which could potentially result in immunothrombosis Despite similar findings from observational studies, these results require confirmation from randomized trials, since reduced mortality rates have been less clear in the absence of disseminated intravascular coagulation (DIC) (4) [ ]response is not only driven by pro-inflammatory cytokines, but also by other detrimental mediators including activated thrombin, heat shock proteins, high-mobility group proteins and the complement system (10) According to observational data, markedly elevated D-dimer levels and the sepsis-induced coagulopathy score are encouraging criteria to guide heparin therapy (15)