Temperature effect on coagulation function in mild hypothermic patients undergoing thoracic surgeries:...

Area of Science:

• Anesthesiology and Perioperative Medicine
• Hematology
• Surgical Coagulation

Background:

• Mild hypothermia is linked to excessive bleeding in thoracic surgeries.
• Standard coagulation tests fail to reveal the mechanisms behind hypothermia-induced bleeding.
• Understanding hypothermia's impact on hemostasis is crucial for patient safety.

Purpose of the Study:

• To investigate how mild hypothermia impairs hemostatic function in thoracic surgery patients.
• To compare coagulation processes using thromboelastography (TEG) between active and passive warming groups.
• To identify specific TEG parameters affected by mild hypothermia.

Main Methods:

• Compared hemostatic function using TEG and standard coagulation tests in patients undergoing thoracic surgery with active vs. passive warming.
• Retested blood samples from the passive warming group using TEG at actual core body temperatures.
• Included sixty-four eligible patients in the comparative analysis.

Main Results:

• Mild hypothermia significantly impaired coagulation, evidenced by decreased Maximum Amplitude (MA) and alpha angle, and prolonged Clotting Time (CT) and K time.
• TEG analysis at actual core body temperatures showed more pronounced coagulation impairment compared to 37°C.
• Patients experiencing mild hypothermia had significantly increased postoperative shivering and delayed waking times.

Conclusions:

• Mild hypothermia significantly impairs coagulation function in thoracic surgery patients.
• TEG is superior to standard coagulation tests in detecting hypothermia-induced hemostatic dysfunction.
• Temperature-adjusted TEG may offer improved hemostatic monitoring and transfusion guidance in thoracic surgeries, warranting further research.