Hemostatic and fibrinolytic indices in neonatal foals with presumed septicemia.

This research studied how septicemia affects neonatal foals’ blood clotting and blood clot dissolution measures. Results showed that septic foals exhibited irregularities in these parameters and such abnormalities had bearings on disease presence, risk of coagulation disorders, and ultimately, survival.

Objective of the Research

• The objective of the study was to scrutinize how septicemia, a severe condition caused by the introduction of bacteria in the blood, affected the hemostatic (blood clotting) and fibrinolytic (blood clot dissolution) indices in newborn foals.

Methods and Participants

• The researchers performed thirteen coagulation tests on two groups of foals: 34 foals with a positive sepsis score and 46 healthy foals for comparison.
• They also measured the foals’ serum cytokine (proteins that aid cell signaling) and plasma endotoxin (toxins released by Gram-negative bacteria cells).

Findings

• Prothrombin, activated partial thromboplastin, and whole blood recalcification times were found significantly longer in septic foals compared to the healthy ones, which indicates disruptions in the natural blood clotting process.
• Higher activities of fibrinogen, fibrin degradation products, percent plasminogen, alpha-2 antiplasmin, plasminogen activator inhibitor activities, and tumor necrosis factor and interleukin-6 were observed in septic foals. These variations show that not only blood clotting but also clot break down were affected. Likewise, the enhanced activities of tumor necrosis factor and interleukin-6 manifest an immune response in the septic foals.
• The level of Protein C, a substance that prevents blood clots, and Antithrombin III, an anticoagulant, were lower in septic foals.
• Nineteen of 29 septic foals had positive blood cultures for growth, and an endotoxin was detected in 15 of 30 septic foals. This signifies the presence and growth of gram-negative bacteria in the bloodstream.
• Among septicemic foals with endotoxin detectable in the plasma, clotting times were exceedingly longer, and activity of plasminogen and antithrombin III was lesser than in septic foals without detected endotoxin.

Outcome

• Out of the 34 septic foals, 23 did not survive. Further, it was most likely for the septic foals to have a positive blood culture indicating the gram-negative bacteria’s presence, which did not survive.
• Sight of hemorrhage was established in 11 foals at the post mortem inspection, and thrombosis was found in 2 foals.
• The prothrombin time was significantly longer in foals that had multisite hemorrhage at the postmortem examination.
• The research concluded that septicemia in neonatal foals does result in significant alterations in blood clotting and clot dissolution processes. These alterations showed relationships with the presence of endotoxin in the blood.
• While these irregularities were useful in identifying septic foals with higher coagulopathy risk, they did not particularly predict the possibility of hemorrhage as compared to thrombus formation.
• It was also found that the survival rate of septic foals correlated with gram-negative bacteremia, but not with the presence of endotoxin or coagulopathy.