Hypothermia Induced Impairment of Platelets: Assessment With Multiplate vs. ROTEM-An In Vitro Study
This experimental study aimed to identify and characterize hypothermia-associated coagulopathy and to compare changes in mild to severe hypothermia with the quantitative measurement of rotational thromboelastometry (ROTEM) and multiple-electrode aggregometry (MULTIPLATE). Whole blood samples from 18...
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Published in | Frontiers in physiology Vol. 13; p. 852182 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Switzerland
Frontiers Media S.A
29.03.2022
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Subjects | |
Online Access | Get full text |
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Summary: | This experimental
study aimed to identify and characterize hypothermia-associated coagulopathy and to compare changes in mild to severe hypothermia with the quantitative measurement of rotational thromboelastometry (ROTEM) and multiple-electrode aggregometry (MULTIPLATE).
Whole blood samples from 18 healthy volunteers were analyzed at the target temperatures of 37, 32, 24, 18, and 13.7°C with ROTEM (ExTEM, InTEM and FibTEM) and MULTIPLATE using the arachidonic acid 0.5 mM (ASPI), thrombin receptor-activating peptide-6 32 µM (TRAP) and adenosine diphosphate 6.4 µM (ADP) tests at the corresponding incubating temperatures for coagulation assessment.
Compared to baseline (37°C) values ROTEM measurements of clotting time (CT) was prolonged by 98% (at 18°C), clot formation time (CFT) was prolonged by 205% and the alpha angle dropped to 76% at 13.7°C (
< 0.001). At 24.0°C CT was prolonged by 56% and CFT by 53%. Maximum clot firmness was only slightly reduced by ≤2% at 13.7°C. Platelet function measured by MULTIPLATE was reduced with decreasing temperature (
< 0.001): AUC at 13.7°C -96% (ADP), -92% (ASPI) and -91% (TRAP).
Hypothermia impairs coagulation by prolonging coagulation clotting time and by decreasing the velocity of clot formation in ROTEM measurements. MULTIPLATE testing confirms a linear decrease in platelet function with decreasing temperatures, but ROTEM fails to adequately detect hypothermia induced impairment of platelets. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Nathan White, University of Washington, United States This article was submitted to Environmental, Aviation and Space Physiology, a section of the journal Frontiers in Physiology Edited by: Tatiana Borisova, Palladin Institute of Biochemistry (NAS Ukraine), Ukraine Reviewed by: Hayley Louise Letson, James Cook University, Australia |
ISSN: | 1664-042X 1664-042X |
DOI: | 10.3389/fphys.2022.852182 |