title: Lipopolysaccharide-induced activation of coagulation in neonatal cord and adult blood monitored by thrombelastography.
abstract: BACKGROUND
  Although precisely balanced hemostasis in newborns is rapidly changing during early development. During gram-negative sepsis, lipopolysaccharide (LPS) activates toll-like receptor (TLR) 4 and induces complex responses of immune system and hemostasis. In the present study we compared LPS-induced activation of coagulation in cord blood (CB) samples of healthy newborns to whole blood (WB) samples from healthy adult volunteers.
  
  
  METHODS
  Samples were incubated with LPS for various incubation periods (0-2-3-4 hrs), and coagulation was measured by rotation thrombelastography (TEG).
  
  
  RESULTS
  All parameters (clotting time (CT), clot formation time (CFT), maximal clot formation (MCF), and angle alpha) were affected with increasing incubation period with LPS (100 ng/ml) in adult and cord WB. In the absence of LPS, CTs and CFTs were significantly shorter and MCFs and angels alpha were significantly longer in cord than in adult WB samples. Reduction of CT due to LPS incubation was significantly stronger in CB than in adult WB samples. Pyrrolidine dithiocarbamate, a specific inhibitor of the NFkappaB pathway, inhibited the effects of LPS on CT in adult and cord WB.
  
  
  CONCLUSIONS
  In summary, TEG proved to be a sensitive and reliable tool for the determination of LPS-induced tissue factor mediated activation of hemostasis in whole blood samples from adults and neonates.
authors.affiliation: Division of Neonatology, Department of Paediatrics, University of Heidelberg Medical School, Im Neuenheimer Feld 430, Heidelberg, Germany. lutz.koch@med.uni-heidelberg.de
authors.forename: Lutz
authors.initials: L
authors.lastname: Koch
authors.forename: Stefan
authors.initials: S
authors.lastname: Hofer
authors.forename: Markus A
authors.initials: MA
authors.lastname: Weigand
authors.forename: David
authors.initials: D
authors.lastname: Frommhold
authors.forename: Johannes
authors.initials: J
authors.lastname: Poeschl
mesh_terms: D000328:Adult; D001777:Blood Coagulation / Q000187:drug effects*; D005312:Fetal Blood / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D008070:Lipopolysaccharides / Q000494:pharmacology*; D012016:Reference Values; D015203:Reproducibility of Results; D013916:Thrombelastography / Q000379:methods*; D014914:Whole Blood Coagulation Time
chemical_list: D008070:Lipopolysaccharides