Effects of temperature on bleeding time and clotting time in normal male and female volunteers

Valeri, C. R.; Macgregor, H.; Cassidy, G.; Tinney, R; Pompei, F.

doi:10.1097/00003246-199504000-00019

Cited by 165 publications

(146 citation statements)

References 22 publications

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“…Although studies have been widely conducted, the bleeding time test does not strictly correlate with surgical bleeding. 41,43 Nonetheless, with standardized techniques and knowledge of the merits and limitations of the bleeding time test, it is useful for diagnosing hemostasis disorders, guiding their therapy and warning of unexpected bleeding complications in surgical patients. 44 Stensrud et al 45 evaluated the effects of intraoperative hypothermia on blood transfusion during cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

The role of perioperative warming in surgery: a systematic review

et al. 2009

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OBJECTIVE: The objective of this review was to systematically analyze the trials on the effectiveness of perioperative warming in surgical patients. METHODS:A systematic review of the literature was undertaken. Clinical trials on perioperative warming were selected according to specific criteria and analyzed to generate summative data expressed as standardized mean difference (SMD). RESULTS:Twenty-five studies encompassing 3,599 patients in various surgical disciplines were retrieved from the electronic databases. Nineteen randomized trials on 1785 patients qualified for this review. The no-warming group developed statistically significant hypothermia. In the fixed effect model, the warming group had significantly less pain and lower incidence of wound infection, compared with the no-warming group. In the random effect model, the warming group was also associated with lower risk of post-anesthetic shivering. Both in the random and the fixed effect models, the warming group was associated with significantly less blood loss. However, there was significant heterogeneity among the trials.CONCLUSION: Perioperative warming of surgical patients is effective in reducing postoperative wound pain, wound infection and shivering. Systemic warming of the surgical patient is also associated with less perioperative blood loss through preventing hypothermia-induced coagulopathy. Perioperative warming may be given routinely to all patients of various surgical disciplines in order to counteract the consequences of hypothermia. RESUMOOBJETIVO: O objetivo desta revisão é analisar sistematicamente os ensaios sobre a eficácia do aquecimento perioperatório em pacientes cirúrgicos. MÉTODOS:Uma revisão sistemática da literatura foi realizada. Ensaios clínicos sobre aquecimento perioperatório foram selecionados segundo critérios específicos e analisados para gerar dados sumativo expresso na diferença média padronizada (standardized mean difference, SMD). RESULTADOS:Vinte e cinco estudos englobando 3.599 pacientes de várias disciplinas de cirurgia foram obtidos a partir de bases de dados eletrônicas.Dezenove ensaios aleatórios em 1.785 pacientes qualificados para esta revisão. Nenhum grupo de aquecimento desenvolveu estatisticamente significativa hipotermia. No modelo de efeito fixo, grupo de aquecimento tiveram significativamente menos dor e menor incidência de infecção na ferida quando comparado com o grupo de não-aquecimento. No modelo de efeito aleatório, grupo de aquecimento também foi associado a um menor risco de tremores pós-anestesia. Em ambos os modelos de efeitos fixos e aleatórios, o aquecimento foi significativamente associado com menor perda de sangue. No entanto, houve significativa heterogeneidade entre os ensaios.CONCLUSÃO: O aquecimento perioperatório de pacientes cirúrgicos é eficaz na redução da dor pós-operatória ferida, infecção ferida, e tremores. O aquecimento sistêmico do paciente cirúrgico também está associado com menor perda de sangue no perioperatório prevenindo hipotermia e induzindo coagulopatia. O ...

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Section: Discussionmentioning

confidence: 99%

The role of perioperative warming in surgery: a systematic review

et al. 2009

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Section: Discussionmentioning

confidence: 99%

“…Hypothermia and acidosis are common complications in severely injured patients [1,2]. The negative impact of these conditions on coagulation resulting in coagulopathy has been well described [3][4][5][6][7][8][9].Desmopressin is a synthetic analogue of vasopressin (1-deamino-8-D-aginine vasopressin, DDAVP). Beside its first indication for treatment of cranial diabetes insipidus, it has become the treatment of choice for von Willebrand disease (Type I) and mild haemophilia A after it was shown that DDAVP leads to increased levels of coagulation factor (F) VIII, von Willebrand factor (vWF), and tissue plasminogen activator [10].…”

mentioning

confidence: 99%

Effects of desmopressin on platelet function under conditions of hypothermia and acidosis: an in vitro study using multiple electrode aggregometry*

Hanke

Dellweg²,

Kienbaum

et al. 2010

Anaesthesia

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SummaryHypothermia and acidosis lead to an impairment of coagulation. It has been demonstrated that desmopressin improves platelet function under hypothermia. We tested platelet function ex vivo during hypothermia and acidosis. Blood samples were taken from 12 healthy subjects and assigned as follows: normal pH, pH 7.2, and pH 7.0, each with and without incubation with desmopressin. Platelet aggregation was assessed by multiple electrode aggregometry. Baseline was normal pH and 36°C. The other samples were incubated for 30 min and measured at 32°C. Acidosis significantly impaired aggregation. Desmopressin significantly increased aggregability during hypothermia and acidosis regardless of pH, but did not return it to normal values at low pH. During acidosis and hypothermia, acidosis should be corrected first; desmopressin can then be administered to improve platelet function as a bridge until normothermia can be achieved. Hypothermia and acidosis are common complications in severely injured patients [1,2]. The negative impact of these conditions on coagulation resulting in coagulopathy has been well described [3][4][5][6][7][8][9].Desmopressin is a synthetic analogue of vasopressin (1-deamino-8-D-aginine vasopressin, DDAVP). Beside its first indication for treatment of cranial diabetes insipidus, it has become the treatment of choice for von Willebrand disease (Type I) and mild haemophilia A after it was shown that DDAVP leads to increased levels of coagulation factor (F) VIII, von Willebrand factor (vWF), and tissue plasminogen activator [10]. It also has been shown to improve platelet function [11][12][13] even under anti-platelet drug therapy [14] or after cardiopulmonary bypass [15]. DDAVP has been shown to correct hypothermia-induced impairment of primary haemostasis partially [16]. The effect of DDAVP under hypothermia and acidosis has not been evaluated to date. Thus, we tested the hypothesis that DDAVP is able to improve platelet function under both hypothermia and acidosis. Anaesthesia, 2010Anaesthesia, , 65, pages 688-691 doi:10.1111Anaesthesia, /j.1365Anaesthesia, -2044Anaesthesia, .2010 Twelve healthy volunteers of Caucasian origin participated in the study after oral and written information and written consent. All volunteers were healthy and with no history of abnormal bleeding nor taking coagulation impairing drugs. Blood was drawn into four 4.5-ml tubes containing 20 lg.ml )1 recombinant hirudin (Dynabyte, Munich, Germany) from a basilic vein using a 18-G cannula. Seven polypropylene tubes were labelled (Tube 1-7) and the collected hirudinised blood was immediately aliquoted into these tubes in 2.7-ml split samples. The test group (DDAVP+) was defined as samples treated with DDAVP. These samples were prepared yielding a final concentration of 1 nM representing an approximate plasma concentration after recommended treatment with DDAVP of 0.3 lg.kg )1 [17]. Samples without treatment with DDAVP were assigned to the control group (DDAVP)). Baseline was defined as a sample without DDAVP treatment ...

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“…[1][2][3] Our laboratory also has used the baboon to study the effects of hypothermia on hemostasis before we conducted the experiments in normal volunteers and patients. [4][5][6][7][8][9][10] We have found that data obtained from baboon studies are similar to those seen in studies of normal volunteers and believe that human studies can be reduced by using the baboon in specific areas of research. The following experiments were performed to evaluate the effects of various disinfection treatments on the survival and function of red blood cells and platelets.…”

Section: The Effect Of Disinfection On Viability and Functionmentioning

confidence: 90%

The Effect of Disinfection on Viability and Function of Baboon Red Blood Cells and Platelets

Valeri¹,

Ragno²,

Macgregor³

et al. 1997

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Blood disinfection is currently being evaluated as a means of reducing or eliminating the risks of disease transmission associated with blood transfusion. For the past 10 years our laboratory has used baboons to evaluate the effects of various disinfection treatments on autologous red blood cell and platelet viability and function in vitro and in vivo. We have used radioactive (51Cr) methods to evaluate the posttransfusion survival and lifespan of disinfected red blood cells. The in vivo recovery and lifespan of platelets were assessed using either radioactive 51Cr or llllndium. The function of the platelets was evaluated by their ability to correct an aspirin-induced thrombocytopathy. We observed that in some instances in which the disinfected autologous red blood cells showed no alterations in vitro measurement, recovery in vivo and lifespan were decreased. In view of these findings, we believe that it is prudent to continue studies in the baboon before attempting studies in normal volunteers.

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Effects of temperature on bleeding time and clotting time in normal male and female volunteers

Abstract: Our data indicate that during surgical procedures, it is important to maintain normothermia to ensure that platelets and clotting proteins function optimally.

Cited by 165 publications

References 22 publications

The role of perioperative warming in surgery: a systematic review

The role of perioperative warming in surgery: a systematic review

Effects of desmopressin on platelet function under conditions of hypothermia and acidosis: an in vitro study using multiple electrode aggregometry*

The Effect of Disinfection on Viability and Function of Baboon Red Blood Cells and Platelets

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