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Establishment of Deep Hypothermic Circulatory Arrest in Rats
Published on: December 16, 2022
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Hypothermic circulatory arrest does not induce coagulopathy in vitro.
Hayato Ise1,2, Kyohei Oyama3, Shingo Kunioka1
1Department of Cardiac Surgery, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan.
Summary
Hypothermia does not cause coagulopathy in vitro. Mock circulation loops (MCL) decrease coagulation by affecting platelets, not hypothermia itself during aortic surgery.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Biomedical Engineering
Background:
- Hypothermic circulatory arrest (HCA) is crucial for aortic surgery to protect organs.
- Hypothermia is suspected to induce coagulopathy, a significant complication.
- Clinical biases necessitate in vitro studies to isolate hypothermia's effect on coagulation.
Purpose of the Study:
- To investigate the independent impact of hypothermia on blood coagulation.
- To differentiate the effects of hypothermia from mechanical factors in circulation.
Main Methods:
- Two in vitro models were used: hypothermic storage and a mock circulation loop (MCL).
- Blood samples were subjected to controlled hypothermia (20°C) and rewarming, simulating HCA.
- Thromboelastography and standard laboratory tests assessed coagulation parameters.
Main Results:
- Hypothermia alone did not impair coagulation in either study model.
- MCL significantly reduced platelet counts and clot elasticity (INTEM/EXTEM).
- Fibrinogen contribution (FIBTEM) remained unaffected, indicating specific platelet-related effects.
Conclusions:
- In vitro hypothermia does not cause irreversible coagulopathy.
- Mock circulation loops, not hypothermia, decrease coagulation primarily through platelet deterioration.
- Findings suggest coagulopathy during HCA may be linked to mechanical circulatory simulation rather than low temperatures alone.
