A systematic evaluation of the effect of temperature on coagulation enzyme activity and platelet function.

Published

Journal Article

BACKGROUND: Hypothermia is associated with an increased risk of bleeding and is a significant contributing factor to the morbidity and mortality of trauma and complicated surgical procedures. A core temperature of 33 degrees C is associated with a significantly increased risk of death after trauma compared with 37 degrees C. Hypothermia-associated bleeding has been hypothesized to result from dysregulation of enzymatic function, reduced platelet activity, and/or altered fibrinolysis. METHODS: We systematically evaluated the effects of temperature on isolated pro- and anticoagulant enzyme processes and platelet activation and adhesion. We also evaluated the effects of temperature on complete coagulation systems (activated partial thromboplastin time and an in vitro, cell-based model of coagulation). RESULTS: Enzyme activities were only slightly reduced at 33 degrees C versus 37 degrees C, and this reduction was not statistically significant (p > 0.05). Platelet activation was also not significantly reduced at 33 degrees C versus 37 degrees C. Conversely, platelet aggregation and adhesion were significantly reduced at 33 degrees C compared with 37 degrees C (p < 0.05). Below 33 degrees C, however, both enzyme activity and platelet function were significantly reduced. CONCLUSION: Our results suggest that bleeding observed at mildly reduced temperatures (33 degrees - 37 degrees C) results primarily from a platelet adhesion defect, and not reduced enzyme activity or platelet activation. However, at temperatures below 33 degrees C, both reduced platelet function and enzyme activity likely contribute to the coagulopathy.

Full Text

Duke Authors

Cited Authors

  • Wolberg, AS; Meng, ZH; Monroe, DM; Hoffman, M

Published Date

  • June 2004

Published In

Volume / Issue

  • 56 / 6

Start / End Page

  • 1221 - 1228

PubMed ID

  • 15211129

Pubmed Central ID

  • 15211129

International Standard Serial Number (ISSN)

  • 0022-5282

Digital Object Identifier (DOI)

  • 10.1097/01.ta.0000064328.97941.fc

Language

  • eng

Conference Location

  • United States