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We tested the hypothesis that mild induced hypothermia reduces coagulation and platelet aggregation in patients with septic shock. Secondary analysis of randomized controlled trial. Adult patients with septic shock who required mechanical ventilation from eight intensive care units in Denmark were randomly assigned to mild induced hypothermia for 24\u2009h or routine thermal management. Viscoelastography and platelet aggregation were assessed at trial inclusion, after 12\u2009h of thermal management, and 24\u2009h after inclusion. A total of 326 patients were randomized to mild induced hypothermia (<jats:italic>n<\/jats:italic>\u2009=\u2009163) or routine thermal management (<jats:italic>n<\/jats:italic>\u2009=\u2009163). Mild induced hypothermia slightly prolonged activated partial thromboplastin time and thrombus initiation time (R time 8.0\u2009min [interquartile range, IQR 6.6\u201311.1] vs. 7.2\u2009min [IQR 5.8\u20139.2]; <jats:italic>p<\/jats:italic>\u2009=\u2009.004) and marginally inhibited thrombus propagation (angle 68\u00b0 [IQR 59\u201373] vs. 71\u00b0 [IQR 63\u201375]; <jats:italic>p<\/jats:italic>\u2009=\u2009.014). The effect was also present after 24\u2009h. Clot strength remained unaffected (MA 71\u2009mm [IQR 66\u201376] with mild induced hypothermia vs. 72\u2009mm (65\u201377) with routine thermal management, <jats:italic>p<\/jats:italic>\u2009=\u2009.9). The proportion of patients with hyperfibrinolysis was not affected (0.7% vs. 3.3%; <jats:italic>p<\/jats:italic>\u2009=\u2009.19), but the proportion of patients with no fibrinolysis was high in the mild hypothermia group (8.8% vs. 40.4%; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). The mild induced hypothermia group had lower platelet aggregation: ASPI 85U (IQR 50\u2013113) versus 109U (IQR 74\u2013148, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), ADP 61U (IQR 40\u201383) versus 79\u2009U (IQR 54\u2013101, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), TRAP 108 (IQR 83\u2013154) versus 119 (IQR 94\u2013146, <jats:italic>p<\/jats:italic>\u2009=\u2009.042) and COL 50U (IQR 34\u201366) versus 67U (IQR 46\u201392, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). In patients with septic shock, mild induced hypothermia slightly impaired clot initiation, but did not change clot strength. Platelet aggregation was slightly impaired. The effect of mild induced hypothermia on viscoelastography and platelet aggregation was however not in a range that would have clinical implications. We did observe a substantial reduction in fibrinolysis.<\/jats:p>","DOI":"10.1111\/aas.14254","type":"journal-article","created":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T11:45:23Z","timestamp":1683027923000},"page":"909-917","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Mild induced hypothermia and coagulation and platelet function in patients with septic shock: Secondary outcome of a randomized trial"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1204-3636","authenticated-orcid":false,"given":"Theis S.","family":"Itenov","sequence":"first","affiliation":[{"name":"CHIP\/PERSIMUNE, Department of infectious diseases, Rigshospitalet Copenhagen University Hospital \u2013 Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Anesthesiology Copenhagen University Hospital \u2013 Bispebjerg  Copenhagen Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria E.","family":"Kromann","sequence":"additional","affiliation":[{"name":"CHIP\/PERSIMUNE, Department of infectious diseases, Rigshospitalet Copenhagen University Hospital \u2013 Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5288-3851","authenticated-orcid":false,"given":"Sisse R.","family":"Ostrowski","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Clinical Immunology Copenhagen University Hospital \u2013 Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6585-2659","authenticated-orcid":false,"given":"Morten H.","family":"Bestle","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Anesthesia and Intensive Care Copenhagen University Hospital \u2013 North Zealand  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Mohr","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Copenhagen University Hospital \u2013 Herlev\u2010Gentofte  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Gyldensted","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Copenhagen University Hospital \u2013 Herlev\u2010Gentofte  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Lindhardt","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Copenhagen University Hospital \u2013 North Zealand  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrin","family":"Thormar","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Copenhagen University Hospital \u2013 Bispebjerg  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9932-3077","authenticated-orcid":false,"given":"Daniel I.","family":"Sessler","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research Anesthesiology Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3039-6574","authenticated-orcid":false,"given":"Nicole P.","family":"Juffermans","sequence":"additional","affiliation":[{"name":"Department of Intensive Care OLVG Hospital  Amsterdam the Netherlands"},{"name":"Laboratory of Experimental Intensive Care and Anesthesiology Amsterdam 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Copenhagen Denmark"},{"name":"Respiratory Section, Department of Internal Medicine Copenhagen University Hospital \u2013 Gentofte  Copenhagen Denmark"},{"name":"Outcomes Research Consortium  Cleveland Ohio 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