Influence of alcohol consumption on blood coagulation in ROTEM: an in-vivo study

• Published in: Korean journal of anesthesiology pp. 334 - 341
• Main Authors: Eismann, Hendrik, Sieg, Lion, Ahmed, Hala, Teske, Joerg, Behrendt, Patrick, Friedrich, Lars, Schumacher, Carsten, Johanning, Kai
• Format: Journal Article
• Language: English
• Published: Korea (South) 대한마취통증의학회 01.08.2020
• Subjects: 마취과학; Ethanol toxicity; Point-of-care testing; Blood coagulation test
• ISSN: 2005-6419; 2005-7563
• DOI: 10.4097/kja.20071

Twenty-five to 85% of trauma patients are under alcohol influence in addition to experiencing injury-related coagulation impairment. The viscoelastic point-of-care test (TEG, ROTEM) has become popular for a rapid assessment of haemostasis and therapeutic decision-making, not only in this setting. Alcohol affects these tests in-vitro, the specific in-vivo effect is unclear. Therefore, we evaluated effects of alcohol ingestion on ROTEM parameters at our department's Christmas party. Twenty volunteers gave informed consent to drinking red wine, whisky or vodka to a target blood alcohol concentration of 1 ‰ within one hour, calculated with the Widmark formula. Blood samples were collected before drinking, at a breath alcohol concentration of 0.5 ‰, and 1.0 ‰, but no later than one hour. After each blood collection, ExTEM and FibTEM tests were performed directly "at the bedside". All of our participants had a blood alcohol concentration (BAC) of 0.00 ‰ at the beginning. The mean BAC at the second and third collection was 0.48 ‰ and 0.76 ‰, respectively. There were no significant differences in the ExTEM parameters. FibTEM measurements showed a significant difference at the A10 value (13.0 vs. 14.0 mm, p = 0.014) and a trend at the maximum amplitude (MCF 13.7 vs. 16.2 mm, p = 0.075). We saw no significant differences in fibrinolysis parameter and also no hyperfibrinolysis in our ROTEM measurements. Ethanol ingestion can impair early fibrin polymerization. Results might be of special relevance in trauma and support routine application of ROTEM/TEG in such cases.