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Wallner B, Schenk B, Hermann M, et al. Hypothermia-Associated Coagulopathy: A Comparison of Viscoelastic Monitoring, Platelet Function, and Real Time Live Confocal Microscopy at Low Blood Temperatures, an . Front Physiol. 2020;11:843doi: 10.3389/fphys.2020.00843.
Wallner, B., Schenk, B., Hermann, M., Paal, P., Falk, M., Strapazzon, G., Martini, W. Z., Brugger, H., & Fries, D. (2020). Hypothermia-Associated Coagulopathy: A Comparison of Viscoelastic Monitoring, Platelet Function, and Real Time Live Confocal Microscopy at Low Blood Temperatures, an . Frontiers in physiology, 11843. https://doi.org/10.3389/fphys.2020.00843
Wallner, Bernd, et al. "Hypothermia-Associated Coagulopathy: A Comparison of Viscoelastic Monitoring, Platelet Function, and Real Time Live Confocal Microscopy at Low Blood Temperatures, an ." Frontiers in physiology vol. 11 (2020): 843. doi: https://doi.org/10.3389/fphys.2020.00843
Wallner B, Schenk B, Hermann M, Paal P, Falk M, Strapazzon G, Martini WZ, Brugger H, Fries D. Hypothermia-Associated Coagulopathy: A Comparison of Viscoelastic Monitoring, Platelet Function, and Real Time Live Confocal Microscopy at Low Blood Temperatures, an . Front Physiol. 2020 Jul 14;11:843. doi: 10.3389/fphys.2020.00843. eCollection 2020. PMID: 32765300; PMCID: PMC7381250.
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Front Physiol. 2020 Jul 14;11:843. doi: 10.3389/fphys.2020.00843. eCollection 2020.

Hypothermia-Associated Coagulopathy: A Comparison of Viscoelastic Monitoring, Platelet Function, and Real Time Live Confocal Microscopy at Low Blood Temperatures, an .

Frontiers in physiology

Bernd Wallner, Bettina Schenk, Martin Hermann, Peter Paal, Markus Falk, Giacomo Strapazzon, Wenjun Z Martini, Hermann Brugger, Dietmar Fries

Affiliations

  1. Department of Anaesthesiology and General Intensive Care Medicine, Medical University of Innsbruck, Innsbruck, Austria.
  2. Department of General and Surgical Intensive Care Medicine, Medical University of Innsbruck, Innsbruck, Austria.
  3. Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.
  4. Department of Anaesthesiology and Intensive Care Medicine, Hospital of the Brothers of St. John of God, Paracelsus Medical University, Salzburg, Austria.
  5. U.S. Army Institute of Surgical Research, Fort Sam Houston, San Antonio, TX, United States.

PMID: 32765300 PMCID: PMC7381250 DOI: 10.3389/fphys.2020.00843

Abstract

INTRODUCTION: Hypothermia has notable effects on platelets, platelet function, fibrinogen, and coagulation factors. Common laboratory techniques cannot identify those effects, because blood samples are usually warmed to 37°C before analysis and do not fully reflect the

METHODS: Blood samples were drawn from 18 healthy volunteers and incubated for 30 min before being analyzed at the target temperatures (37, 32, 24, 18, and 13.7°C). At each temperature thromboelastometry and multiple-electrode aggregometry were measured. Real Time Live Confocal Imaging was performed at 4, 24, and 37°C. The images obtained by Real Time Live Confocal Imaging were compared with the functional results of thromboelastometry and multiple-electrode aggregometry.

RESULTS: Thromboelastometry standard parameters were impaired at temperatures below baseline 37°C (ANOVA overall effect,

CONCLUSION: The inhibitory effects of temperature on clot formation were visualized with Real Time Live Confocal Microscopy and compared with standard point-of-care testing. Inhibition of clotting factors and impaired platelet function are probably a result of hypothermia-induced impairment of thrombin. Measurement of MCF in TEM does not fully concur with Real Time Live Confocal Microscopy or MEA in hypothermia.

Copyright © 2020 Wallner, Schenk, Hermann, Paal, Falk, Strapazzon, Martini, Brugger and Fries.

Keywords: Confocal Microscopy; coagulation; fibrinogen; hypothermia; platelet; platelet activity; viscoelastic testing

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