Abnormalities of Coagulation and Fibrinolysis Assessed by Thromboelastometry in an Endotoxic Shock Model in Piglets Treated with Nitric Oxide and Hydrocortisone.

Publisher: Birkhaüser Country of Publication: Poland NLM ID: 0114365 Publication Model: eCollection Cited Medium: Internet ISSN: 1661-4917 (Electronic) Linking ISSN: 0004069X NLM ISO Abbreviation: Arch Immunol Ther Exp (Warsz) Subsets: MEDLINE

Publication: 2006- : Basel ; Boston : Birkhaüser
Original Publication: Warszawa, Panstwowy Zakład Wydawn. Lekarskich.

Hydrocortisone*/administration & dosage ; Hydrocortisone*/therapeutic use ; Hydrocortisone*/pharmacology ; Nitric Oxide*/metabolism ; Fibrinolysis*/drug effects ; Disease Models, Animal* ; Thrombelastography* ; Blood Coagulation*/drug effects ; Shock, Septic*/drug therapy; Animals ; Swine ; Administration, Inhalation ; Endotoxins/administration & dosage ; Humans ; Blood Coagulation Disorders/drug therapy

This is an animal model study to investigate changes in hemostasis during endotoxemic shock and to determine whether the combination of inhaled nitric oxide (iNO) + intravenous hydrocortisone had an effect on clot formation and fibrinolysis. iNO selectively decreases pulmonary artery pressure, without affecting cardiac index or systemic vascular resistance; however, the results of studies on the possible consequences of iNO administration on coagulation are inconsistent and require further research. Thirty-four piglets were included. Administering endotoxin caused severe hypodynamic shock. Half of the animals received iNO (30 ppm) + hydrocortisone, starting 3 h after endotoxin infusion and continuing to the end of the study. All animals developed coagulation disorders, manifested by a tendency to hypocoagulation; at the same time, fibrinolysis was impaired. Coagulation and fibrinolysis disorders persisted after endotoxin infusion was discontinued, with worse severity in the animals that died before the study was terminated. Administering iNO + hydrocortisone did not cause further changes in coagulation and fibrinolysis parameters, either during or after the endotoxin challenge, suggesting that potential therapeutic interventions with iNO to lower pulmonary arterial pressure will not affect hemostasis.
(© 2024 Barbara Adamik et al., published by Sciendo.)

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Keywords: Coagulation; Endotoxemia; Fibrinolysis; Inhaled nitric oxide; Shock; Thromboelastometry

WI4X0X7BPJ (Hydrocortisone)
31C4KY9ESH (Nitric Oxide)
0 (Endotoxins)

Date Created: 20240607 Date Completed: 20240607 Latest Revision: 20240623

20240623

10.2478/aite-2024-0011

38847555