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Coagulation Changes during Central Hypovolemia across Seasons.

Nandu Goswami¹, Alexander Andreas Taucher¹, Bianca Brix¹

¹Physiology Division, Otto Loewi Research Center, Medical University of Graz, 8036 Graz, Austria.

Journal of Clinical Medicine

|October 30, 2020

Summary

Seasonal variations significantly impact blood coagulation during simulated hemorrhage. Summer conditions promote a more procoagulative state, increasing risks during lower body negative pressure (LBNP) challenges.

Keywords:

LBNP coagulation seasons thrombelastometry thrombin generation trhombogram

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Area of Science:

Physiology
Hematology
Environmental Medicine

Background:

Lower body negative pressure (LBNP) is a validated model for simulating hemorrhage.
Understanding seasonal influences on hemostasis is crucial for physiological research and clinical applications.
Coagulation parameters may exhibit variability influenced by environmental factors like temperature.

Purpose of the Study:

To investigate the impact of seasons (cold vs. warm) on coagulation profiles at rest and during LBNP.
To determine if seasonal differences affect the body's response to simulated hemorrhage.

Main Methods:

Healthy participants underwent LBNP protocols (-10 to -40 mmHg) in cold (Nov-Apr) and warm (May-Oct) seasons.
Blood samples were collected at baseline, during LBNP, and post-LBNP recovery.
Comprehensive hemostatic profiling included standard coagulation tests, calibrated automated thrombogram (CAT), thrombelastometry, aggregometry, and thrombin markers.

Main Results:

Baseline prothrombin (FII), tissue factor (TF), F1+2, and thrombin-antithrombin complex (TAT) were elevated in summer.
LBNP increased Factor VIII, F1+2, TAT, and coagulation time in both seasons.
Summer LBNP induced a more procoagulant shift in CAT parameters (lag, time to peak, peak) compared to winter.
Red blood cell, hemoglobin, and white blood cell counts decreased during LBNP.

Conclusions:

Seasonal variations, particularly higher temperatures in summer, enhance baseline procoagulant markers.
LBNP elicits a procoagulative response, which is more pronounced during summer months.
These findings highlight the significant influence of season on hemostasis and the response to simulated hemorrhage, with potential medical implications.