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Coagulation under Mild Hypothermia Assessed by Thromboelastometry.

Tobias Nitschke1, Philipp Groene1, Alice-Christin Acevedo1

  • 1Department of Anesthesiology, University Hospital, LMU Munich, Munich, Germany.

Transfusion Medicine and Hemotherapy : Offizielles Organ Der Deutschen Gesellschaft Fur Transfusionsmedizin Und Immunhamatologie
|September 20, 2021
PubMed
Summary
This summary is machine-generated.

Mild hypothermia significantly alters blood coagulation, increasing clot formation time and affecting fibrinolysis. Perioperative temperature management is crucial to prevent these adverse effects.

Keywords:
CoagulationHypothermiaRotational thromboelastometryThromboelastographyThromboelastometry

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Area of Science:

  • Anesthesiology
  • Hematology
  • Physiology

Background:

  • Extreme temperature variations impact coagulation, but mild perioperative hypothermia's effects remain understudied.
  • This research investigates the in vitro effects of mild hypothermia on blood coagulation parameters.

Purpose of the Study:

  • To analyze the in vitro impact of mild hypothermia on coagulation using rotational thromboelastometry.
  • To assess changes in clot formation, stability, and fibrinolysis under mild hypothermic conditions.

Main Methods:

  • Coagulation was evaluated in vitro using standard thromboelastometric tests (EXTEM, INTEM, FIBTEM) at temperatures ranging from 33°C to 39°C.
  • A novel TPA-test was employed to assess fibrinolytic capacity under mild hypothermia.
  • Data from 12 healthy volunteers were analyzed, presented as medians with 25th/75th percentiles.

Main Results:

  • Mild hypothermia significantly increased clot formation time (CFT) in both extrinsic (EXTEM) and intrinsic (INTEM) pathways.
  • Maximum clot firmness (MCF) showed no significant reduction, indicating preserved clot stability.
  • Mild hypothermia significantly prolonged lysis onset time and lysis time, suggesting impaired fibrinolysis.

Conclusions:

  • Even mild hypothermia significantly alters coagulation in vitro.
  • Perioperative temperature monitoring and management are essential to mitigate adverse coagulation effects.
  • Further in vivo studies are warranted to confirm these findings under physiological conditions.