Matt Harmon

121 Chapter six Citrated whole blood was analysed with the rotational thromboelastometry (ROTEM) delta device at 37°C. The variables measured were: coagulation time (CT), clot formation time (CFT), clot amplitude after 5, 10, 15, 20, 25, and 30 minutes (CA-5, -10, -15, -20, -25, -30), α -angle (alpha), maximum clot firmness (MCF), clot lysis at 30, 45, and 60 min (LI30, 45, and 60), and the maximum lysis in percentage (ML). If an error appeared during the test or it seemed that a subtest (like extrinsically activated test (EXTEM), intrinsically activated test (INTEM) or fibrin-based extrinsically activated test (FIBTEM)) did not run properly, that particular test was repeated immediately with blood retrieved from the same sample in order to provide a reliable result. The G-value was assessed using the formula (5,000 × MCF) / (100 – MCF) and expressed as dynes/cm2. 10 The systemic inflammatory response syndrome (SIRS) score was calculated according to the Bone criteria. 11 The DIC-score was calculated according to the International Society on Thrombosis and Haemostasis (ISTH) guideline. 12 Statistical analysis Statistical analyses were performed using R studio version 1.3. Depending on normality of the data, baseline differences between groups were calculated with either the students T-test or the Wilcoxon ranked sums test. To compare changes over time within groups, a paired students T-test or the Wilcoxon ranked sums test was performed between T=0 and the maximum or minimum value during the study period. Linear mixed models were used to analyse differences in continuous variables between groups over time, using timepoint and group as fixed effects and subject ID as random effect. Nested models with and without group as a variable were compared to determine differences between groups. If data were non-parametric, data were transformed prior to statistical testing. Normally distributed data were presented as mean ± standard deviation. Non-parametric data were presented as median (25-75th percentile). Results from the linear mixed models were presented as Beta-coefficient (b) and 95% confidence interval (95% CI). A p-value below 0.05 was considered statistically significant. Results The impact of fever control on the physiologic response to LPS-infusion LPS resulted in fever in the fever group with a mean peak temperature of 38.7°C (±0.3) at t=3 hours after LPS-infusion. In the normothermia group, body temperature was significantly lower (p<0.0001), with mean peak temperature at t=3 hours of 37.2°C (±0.3). LPS resulted in an increased heart rate (58.7 ± 6.1