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Coagulation defects resulting from ambient temperature-induced hypothermia

D B Staab1, V J Sorensen, J J Fath

  • 1Division of Trauma and Critical Care Surgery, Henry Ford Hospital, Detroit, Michigan 48202.

The Journal of Trauma
|May 1, 1994
PubMed
Summary

Hypothermia in trauma patients can cause bleeding issues, even with normal coagulation tests. This study in minipigs confirmed significant coagulation defects during hypothermia and rewarming.

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Area of Science:

  • Biomedical Science
  • Trauma Research
  • Coagulation Physiology

Background:

  • Hypothermia in trauma patients often correlates with bleeding diathesis.
  • This bleeding tendency persists despite seemingly normal laboratory coagulation parameters.

Purpose of the Study:

  • To investigate the impact of ambient temperature-induced hypothermia on coagulation and platelet function.
  • To determine if hypothermia causes coagulation defects in a porcine model.

Main Methods:

  • Coagulation and platelet function studies were performed on ten minipigs during induced whole body hypothermia (34°C) and rewarming.
  • Comparative analysis included ex vivo cooling and rewarming of plasma samples in a water bath.
  • Platelet counts, Sonoclot analysis, aggregation, prothrombin time (PT), and activated partial thromboplastin time (aPTT) were assessed.

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Main Results:

  • Hypothermia did not significantly affect platelet counts or function in either model.
  • Ex vivo cooled plasma showed abnormal PT and aPTT.
  • In vivo whole body hypothermia resulted in abnormal bleeding time and PT.
  • Coagulation defects were most pronounced during the rewarming phase.

Conclusions:

  • Ambient temperature-induced hypothermia causes significant coagulation defects in a porcine model.
  • These defects, particularly evident during rewarming, may explain bleeding complications in trauma patients.
  • Platelet function appears preserved, suggesting the primary issue lies within plasma-based coagulation factors.