Universität zu Köln

Nitschke, Tobias, Groene, Philipp ORCID: 0000-0001-8357-5552, Acevedo, Alice-Christin, Kammerer, Tobias ORCID: 0000-0001-8920-7187 and Schaefer, Simon T. (2021). Coagulation under Mild Hypothermia Assessed by Thromboelastometry. Transfus. Med. Hemother., 48 (4). S. 203 - 210. BASEL: KARGER. ISSN 1660-3818

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Abstract

Introduction: While previous studies have shown a significant impact of extreme hypo- and hyperthermia on coagulation, effects of much more frequently occurring perioperative mild hypothermia are largely unknown. This study therefore aimed to analyze the effects of mild hypothermia using rotational thromboelastometry in vitro. Materials and Methods: Twelve healthy volunteers were included in this study. Standard thromboelastometric tests (EXTEM, INTEM, FIBTEM) were used to evaluate coagulation in vitro at 39, 37, 35.5, 35, and 33 degrees C. Beyond standard thromboelastometric tests, we also evaluated the effects of mild hypothermia on the TPA-test (ClotPro, Enicor GmbH, Munich, Germany), a new test which aims to detect fibrinolytic capacity by adding tissue plasminogen activator to the sample. Data are presented as the median with 25/75th percentiles. Results: Extrinsically activated coagulation (measured by EXTEM) showed a significant increase in clot formation time (CFT; 37 degrees C: 90 s [81/105] vs. 35 degrees C: 109 s [99/126]; p = 0.0002), while maximum clot firmness (MCF) was not significantly reduced. Intrinsically activated coagulation (measured by INTEM) also showed a significant increase in CFT (37 degrees C: 80 s [72/88] vs. 35 degrees C: 94 s [86/109]; p = 0.0002) without significant effects on MCF. Mild hypothermia significantly increased both the lysis onset time (136 s [132/151; 37 degrees C] vs. 162 s [141/228; 35 degrees C], p = 0.0223) and lysis time (208 s [184/297; 37 degrees C] vs. 249 s [215/358; 35 degrees C]; p = 0.0259). Conclusion: This demonstrates that even under mild hypothermia coagulation is significantly altered in vitro. Perioperative temperature monitoring and management are greatly important and can help to prevent mild hypothermia and its adverse effects. Further investigation and in vivo testing of coagulation under mild hypothermia is needed. (c) 2021 S. Karger AG, Basel

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Nitschke, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Groene, Philipp UNSPECIFIED orcid.org/0000-0001-8357-5552 UNSPECIFIED Acevedo, Alice-Christin UNSPECIFIED UNSPECIFIED UNSPECIFIED Kammerer, Tobias UNSPECIFIED orcid.org/0000-0001-8920-7187 UNSPECIFIED Schaefer, Simon T. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-575104
DOI:	10.1159/000513922
Journal or Publication Title:	Transfus. Med. Hemother.
Volume:	48
Number:	4
Page Range:	S. 203 - 210
Date:	2021
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1660-3818
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BLOOD-LOSS; COAGULOPATHY; ACIDOSIS; TRAUMA Multiple languages Hematology; Immunology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/57510