Coagulation defects resulting from ambient temperature-induced hypothermia

Ambient temperature-induced hypothermia noted in trauma patients is frequently accompanied by a bleeding diathesis despite "laboratory normal" coagulation values. To document this impression, the following experiment was conducted. Coagulation studies and platelet function studies were performed in ten minipigs during induced whole body hypothermia (40 degrees C to 34 degrees C) and rewarming. Cooling was achieved in 2 to 3 hours and rewarming took 4 to 5 hours. In addition, similar coagulation and platelet function studies were conducted on plasma samples from the same animals that were cooled and then rewarmed in a water bath. Platelet counts and function as measured by Sonoclot analysis and aggregation did not decrease significantly with hypothermia in either model. Plasma cooled in a water bath demonstrated abnormal PT and aPTT (p < 0.001). Whole body hypothermia demonstrated abnormal bleeding time and PT (p < 0.001). Ambient temperature-induced hypothermia produced significant coagulation defects in a porcine model. Some of the coagulation defects were most pronounced during rewarming.