Second Neonatal Department and Neonatal Intensive Care Unit (NICU), “Papageorgiou” General Hospital, Medical School, Aristotle University of Thessaloniki, Nea Efkarpia, 56403 Thessaloniki, Greece
Georgios Mitsiakos
Second Neonatal Department and Neonatal Intensive Care Unit (NICU), “Papageorgiou” General Hospital, Medical School, Aristotle University of Thessaloniki, Nea Efkarpia, 56403 Thessaloniki, Greece
Georgios N. Katsaras
Second Neonatal Department and Neonatal Intensive Care Unit (NICU), “Papageorgiou” General Hospital, Medical School, Aristotle University of Thessaloniki, Nea Efkarpia, 56403 Thessaloniki, Greece
Christos-Georgios Kontovazainitis
Second Neonatal Department and Neonatal Intensive Care Unit (NICU), “Papageorgiou” General Hospital, Medical School, Aristotle University of Thessaloniki, Nea Efkarpia, 56403 Thessaloniki, Greece
Paraskevi Karagianni
First Neonatal Department and Neonatal Intensive Care Unit (NICU), “Hippokration” General Hospital, Medical School, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
Emmanuel Roilides
Third Department of Paediatrics, Hippokration University Hospital, Medical School, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
Gili Kenet
National Hemophilia Center, Thrombosis Unit and Amalia Biron Research Institute of Thrombosis and Hemostasis, Sheba Medical Center, Tel-Hashomer 52621, Israel
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.
