Hypothermia-Induced Coagulopathy During Hemorrhagic Shock

Krause, Kevin R.; Howells, Greg A.; Buhs, Chad L.; Hernandez, Diego A.; Bair, Holly; Schuster, Michelle; Bendick, Phillip J.
April 2000
American Surgeon;Apr2000, Vol. 66 Issue 4, p348
Academic Journal
A porcine model of hemorrhagic shock was used to study the effect of hypothermia on hemodynamic, metabolic, and coagulation parameters. The model was designed to simulate the events of severe blunt injury with hemorrhage occurring initially, to a systolic blood pressure of 30 mm Hg, followed by simultaneous hemorrhage and crystalloid volume replacement, followed by cessation of hemorrhage and blood replacement. Half of the animals were rendered hypothermic by external application of ice, and half remained normothermic. There was seven pigs in each group. Two deaths occurred in each during the hemorrhage phase. The hypothermic pigs demonstrated larger reduction in cardiac output than normothermic pigs. Volume replacement in the normothermic group restored cardiac output to baseline values. In the hypothermic group, cardiac output remained depressed despite volume replacement. Prothrombin times and partial thromboplastin times showed significantly more prolongation in the hypothermic group. Furthermore, this was not corrected by replacement of shed blood in the hypothermic group, as was seen in the normothermic group. We conclude that when shock and hypothermia occur together, their deleterious effect on hemodynamic and coagulation parameters are additive. The effects of hypothermia persist despite the arrest of hemorrhage and volume replacement. Thus, it is necessary to aggressively address both shock and hypothermia when they occur simultaneously.


Related Articles

  • Effects of Mild Hypothermia on Coagulation Tests and Haemodynamic Variables in Anaesthetized Rabbits. Staikou, C.; Paraskeva, A.; Donta, I.; Theodossopoulos, T.; Anastassopoulou, I.; Kontos, M. // West Indian Medical Journal;Oct2011, Vol. 60 Issue 5, p513 

    Objective: Hypothermia has been associated with coagulation defects. The purpose of this experimental study was to investigate the effect of mild hypothermia on clinically used coagulation tests and on haemodynamic variables. Methods: Nine New Zealand rabbits were subjected to mild core...

  • Severe Hypothermia Induced by Dipyrone Overdose. Margolin, L.; Engelhard, D. // Clinical Drug Investigation;2002, Vol. 22 Issue 6, p407 

    Dipyrone is an effective, non-opioid analgesic that was originally introduced in 1922. However, because of the adverse effects of other related pyrazolone derivatives, its administration was significantly limited. Later, dipyrone was used, usually mixed, with spasmolytic agents, and quite...

  • Hemodynamic Characteristics of Patients with Hypothermia Due to Occult Infection and Other Causes. Morris, D. Lynn; Chambers, Henry F.; Morris, Mary Gayle; Sande, Merle A. // Annals of Internal Medicine;Feb85, Vol. 102 Issue 2, p153 

    Presents information on a study which described the hemodynamic characteristics of patients with hypothermia due to severe infection. Methodology; Results; Discussion.

  • The antiinflammatory effects of propofol in endotoxemic rats during moderate and mild hypothermia. Kanakura, Hiroko; Taniguchi, Takumi // Journal of Anesthesia;2007, Vol. 21 Issue 3, p354 

    We previously found that propofol attenuated the mortality rate and inflammatory responses during endotoxemia in rats; however, whether propofol retains its antiinflammatory effects during hypothermia has not been determined. We investigated the effects of propofol on endotoxemic rats subjected...

  • Effects of sympathetic stimulation during cooling on hypothermic as well as posthypothermic hemodynamic function. Kondratiev, T. V.; Tveita, T. // Canadian Journal of Physiology & Pharmacology;Oct2006, Vol. 84 Issue 10, p985 

    This experimental study was performed to explore hemodynamic effects of a moderate dose epinephrine (Epi) during hypothermia and to test the hypothesis whether sympathetic stimulation during cooling affects myocardial function following rewarming. Two groups of male Wistar rats (each, n = 7)...

  • Cooling to 10°C and treatment with Cyclosporine A improve cerebral recovery following prolonged hypothermic circulatory arrest in a chronic porcine model Strauch, Justus T.; Spielvogel, David; Haldenwang, Peter L.; Zhang, Ning; Weisz, Donald; Bodian, Carol A.; Tatton, Nadine A.; Griepp, Randall B. // European Journal of Cardio-Thoracic Surgery;Jan2005, Vol. 27 Issue 1, p74 

    Abstract: Objective: This study was undertaken to assess whether cooling to 10°C and/or treatment with Cyclosporine A (CsA) can reduce neurological injury during prolonged hypothermic circulatory arrest (HCA) in a chronic animal model. Methods: In this blinded study, 24 pigs (20–23kg)...

  • Potential Applications of Hydrogen Sulfide-Induced Suspended Animation. Aslami, Hamid; Schultz, Marcus J.; Juffermans, Nicole P. // Current Medicinal Chemistry;Apr2009, Vol. 16 Issue 10, p1295 

    A suspended animation-like state has been induced in rodents with the use of hydrogen sulfide, resulting in hypothermia with a concomitant reduction in metabolic rate. Also oxygen demand was reduced, thereby protecting against hypoxia. Several therapeutic applications of induction of a...

  • Treatment of severe accidental hypothermia with intermittent hemodialysis. Sultan, Nabil; Theakston, Karl D.; Butler, Ron; Suri, Rita S. // CJEM: Canadian Journal of Emergency Medicine;Mar2009, Vol. 11 Issue 2, p174 

    The optimal management of moderate-to-severe hypothermia with hemodynamic instability remains unclear. Although cardiopulmonary bypass offers the most rapid rate of rewarming and has been suggested as the method of choice in the presence of circulatory arrest, there is no evidence to support the...

  • Systemic and Cerebral Haemodynamics During Craniotomy Under Mild Hypothermia in Patients with Acute Subarachnoid Haemorrhage. Sato, K.; Yoshimoto, T. // Acta Neurochirurgica;Sep2000, Vol. 142 Issue 9, p1013 

    Summary¶ Background. Mild hypothermia provides cerebral protection against ischaemic insults in various animal models. We compared systemic and cerebral oxygenation between mild hypothermic and normothermic management in 60 patients with acute subarachnoid haemorrhage who underwent clipping...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics