Gialamprinou Dimitra, Mitsiakos Georgios, Katsaras Georgios N, Kontovazainitis Christos-Georgios, Karagianni Paraskevi, Roilides Emmanuel, Kenet Gili
Second Neonatal Department and Neonatal Intensive Care Unit (NICU), "Papageorgiou" General Hospital, Medical School, Aristotle University of Thessaloniki, Nea Efkarpia, 56403 Thessaloniki, Greece.
First Neonatal Department and Neonatal Intensive Care Unit (NICU), "Hippokration" General Hospital, Medical School, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece.
Diagnostics (Basel). 2022 Jan 20;12(2):261. doi: 10.3390/diagnostics12020261.
Neonatal sepsis is considered critical for a significant increase in neonatal morbidity and mortality among hospitalized neonates. Neonatal sepsis, in most cases, coexists with coagulopathy, which can prove to be life-threatening. Complex molecular and cellular systems are involved in the cross-talk between inflammation and hemostasis during sepsis. Disturbances in the regulating systems of the vascular endothelium, and platelet-endothelial and platelet-neutrophil interactions play a pivotal role in both inflammation and coagulation. This complex process is poorly understood in neonates. In addition to the developmental maturation of hemostasis and the immune response in neonatal sepsis, a cellular model of hemostasis during sepsis should be taken into account. This review focused on the molecular and cellular mechanisms underlying inflammation and hemostasis during neonatal sepsis, taking the developmental immune response and developmental hemostasis into account in order to provide future diagnostic approaches to be applied in everyday clinical settings. Regarding the diagnostic modalities, we briefly provide the limitations of the currently used conventional coagulation assays, focusing on viscoelastic tests and platelet flow cytometry.
新生儿败血症被认为是导致住院新生儿发病率和死亡率显著上升的关键因素。在大多数情况下，新生儿败血症与凝血病共存，这可能会危及生命。败血症期间，炎症和止血之间的相互作用涉及复杂的分子和细胞系统。血管内皮调节系统、血小板 - 内皮以及血小板 - 中性粒细胞相互作用的紊乱在炎症和凝血过程中都起着关键作用。这一复杂过程在新生儿中尚未得到充分理解。除了新生儿败血症中止血和免疫反应的发育成熟外，还应考虑败血症期间止血的细胞模型。本综述聚焦于新生儿败血症期间炎症和止血的分子及细胞机制，同时考虑发育免疫反应和发育止血，以便为日常临床应用提供未来的诊断方法。关于诊断方式，我们简要介绍了当前常用传统凝血检测的局限性，重点关注粘弹性试验和血小板流式细胞术。
