Thromboelastometry (TEM) findings in disseminated XXXX in a @entity1707 model of endotoxinemia.

@entity1707 @entity3459 @entity5642 @entity25794 @entity4461 @entity35373
Standard coagulation tests have a low specificity and sensitivity for diagnosing disseminated @entity5642 . The aim of this study was to determine whether whole blood thromboelastometry (TEM) detects lipopolysaccharide (LPS)-induced changes in coagulation. Blood samples from 10 @entity1707 were drawn at baseline, before and at the end of LPS infusion and 2, 3, 4 and 5 h after the start of endotoxinemia. Simultaneous to TEM, standard coagulation tests and extended coagulation analysis including tissue plasminogen activator ( @entity35373 ) and @entity25794 ( @entity25794 ) were performed. Endotoxinemia resulted in a significant acceleration of the nonactivated TEM (NATEM) clotting time 2 h after the end of LPS infusion; in contrast, the changes in international normalized ratio and activated partial thromboplastin time suggested delayed @entity3459 . NATEM @entity4461 ( @entity4461 ) and fibrin-based thromboelastometry test (FIBTEM)- @entity4461 decreased significantly from baseline until the last time point (from 64.6    7.8 and 35.1    12.8 mm to 52.8    4.6 and 21.4    11.8 mm, respectively; P = 0.01 for both parameters). A sharp, transient increase of @entity35373 had no effect on maximum lysis in the NATEM test. @entity25794 increased significantly 3 h after the start of LPS infusion, paralleled by a decrease in maximum lysis. In conclusion, TEM was superior to standard coagulation tests in reflecting initial activation of coagulation during endotoxinemia. TEM further suggested consumption of coagulation substrate; at the same time, inhibition of plasminogen activation was accompanied by improved clot stability. Further investigations are necessary to establish the clinical relevance of these findings.
