TNF and Disseminated intravascular coagulation: Elevated levels of endothelin-1 contribute to inflammatory activation and increased production of IL-1, TNF-α and IL-6; while higher syndecan-1, endothelin-1, and VCAM-1 are associated with worse prognosis in sepsis.36, 37, 38, 39 PAI-1 is a fibrinolysis inhibitor classically linked to disseminated intravascular coagulation, and may be involved in the YF coagulopathy, with high prevalence of hemorrhages.