Enhanced Blood Clotting After Rewarming From Experimental Hypothermia in an Intact Porcine Model.

Autor:	Schanche T; Department of Clinical Medicine, Anaesthesia and Critical Care Research Group, UiT The Arctic University of Norway, Tromsø, Norway.; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States., Filseth OM; Department of Clinical Medicine, Anaesthesia and Critical Care Research Group, UiT The Arctic University of Norway, Tromsø, Norway.; Division of Surgical Medicine and Intensive Care, University Hospital of North Norway, Tromsø, Norway., Østerud B; Thrombosis Research Center, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway., Kondratiev TV; Department of Clinical Medicine, Anaesthesia and Critical Care Research Group, UiT The Arctic University of Norway, Tromsø, Norway., Sieck GC; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States., Tveita T; Department of Clinical Medicine, Anaesthesia and Critical Care Research Group, UiT The Arctic University of Norway, Tromsø, Norway.; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States.; Division of Surgical Medicine and Intensive Care, University Hospital of North Norway, Tromsø, Norway.
Jazyk:	angličtina
Zdroj:	Frontiers in physiology [Front Physiol] 2022 Apr 29; Vol. 13, pp. 901908. Date of Electronic Publication: 2022 Apr 29 (Print Publication: 2022).
DOI:	10.3389/fphys.2022.901908
Abstrakt:	Introduction: Due to functional alterations of blood platelets and coagulation enzymes at low temperatures, excessive bleeding is a well-recognized complication in victims of accidental hypothermia and may present a great clinical challenge. Still, it remains largely unknown if hemostatic function normalizes upon rewarming. The aim of this study was to investigate effects of hypothermia and rewarming on blood coagulation in an intact porcine model. Methods: The animals were randomized to cooling and rewarming ( n = 10), or to serve as normothermic, time-matched controls ( n = 3). Animals in the hypothermic group were immersion cooled in ice water to 25°C, maintained at 25°C for 1 h, and rewarmed to 38°C (normal temperature in pigs) using warm water. Clotting time was assessed indirectly at different temperatures during cooling and rewarming using a whole blood coagulometer, which measures clotting time at 38°C. Results: Cooling to 25°C led to a significant increase in hemoglobin, hematocrit and red blood cell count, which persisted throughout rewarming. Cooling also caused a transiently decreased white blood cell count that returned to baseline levels upon rewarming. After rewarming from hypothermia, clotting time was significantly shortened compared to pre-hypothermic baseline values. In addition, platelet count was significantly increased. Discussion/Conclusion: We found that clotting time was significantly reduced after rewarming from hypothermia. This may indicate that rewarming from severe hypothermia induces a hypercoagulable state, in which thrombus formation is more likely to occur. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Schanche, Filseth, Østerud, Kondratiev, Sieck and Tveita.)
Databáze:	MEDLINE
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