The effects of low‐dose epinephrine infusion on spleen size, central and hepatic circulation and circulating platelets

Baković, Darija; Pivac, Nediljko; Eterović, Davor; Brešković, Toni; Zubin, Petra; Obad, Ante; Dujić, Željko

doi:10.1111/j.1475-097x.2012.01156.x

Cited by 60 publications

(49 citation statements)

References 41 publications

(85 reference statements)

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“…More specifically, it has been recently demonstrated that the hyperactive platelets generated during exercise are rapidly cleared by the spleen, which is also a dynamic reservoir of younger and larger platelets (i.e., the human spleen retains one-third of total body platelets, with MPV approximately 20% greater than that of circulating platelets) [23]. The younger platelets are then released into the circulation, thus explaining the significant increase of platelet count and MPV observed after endurance exercise in this and other previous studies [18]–[22].…”

Section: Discussionmentioning

confidence: 99%

Mean Platelet Volume (MPV) Predicts Middle Distance Running Performance

et al. 2014

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BackgroundRunning economy and performance in middle distance running depend on several physiological factors, which include anthropometric variables, functional characteristics, training volume and intensity. Since little information is available about hematological predictors of middle distance running time, we investigated whether some hematological parameters may be associated with middle distance running performance in a large sample of recreational runners.MethodsThe study population consisted in 43 amateur runners (15 females, 28 males; median age 47 years), who successfully concluded a 21.1 km half-marathon at 75–85% of their maximal aerobic power (VO2max). Whole blood was collected 10 min before the run started and immediately thereafter, and hematological testing was completed within 2 hours after sample collection.ResultsThe values of lymphocytes and eosinophils exhibited a significant decrease compared to pre-run values, whereas those of mean corpuscular volume (MCV), platelets, mean platelet volume (MPV), white blood cells (WBCs), neutrophils and monocytes were significantly increased after the run. In univariate analysis, significant associations with running time were found for pre-run values of hematocrit, hemoglobin, mean corpuscular hemoglobin (MCH), red blood cell distribution width (RDW), MPV, reticulocyte hemoglobin concentration (RetCHR), and post-run values of MCH, RDW, MPV, monocytes and RetCHR. In multivariate analysis, in which running time was entered as dependent variable whereas age, sex, blood lactate, body mass index, VO2max, mean training regimen and the hematological parameters significantly associated with running performance in univariate analysis were entered as independent variables, only MPV values before and after the trial remained significantly associated with running time. After adjustment for platelet count, the MPV value before the run (p = 0.042), but not thereafter (p = 0.247), remained significantly associated with running performance.ConclusionThe significant association between baseline MPV and running time suggest that hyperactive platelets may exert some pleiotropic effects on endurance performance.

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Section: Discussionmentioning

confidence: 99%

Mean Platelet Volume (MPV) Predicts Middle Distance Running Performance

et al. 2014

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“…This is consistent with the role of epinephrine in promoting platelet aggregation and several coagulation factor release. [12,13] Although low doses of epinephrine can cause beta-adrenergic activation, resulting in decreased peripheral vascular resistance and increased circulating blood volume, this effect disappears within 5 minutes of cessation of epinephrine administration. [13] Therefore, this hemodynamic effect did not significantly affect the procoagulant and hemostatic effects of epinephrine.…”

Section: Discussionmentioning

confidence: 99%

The efficacy and safety of epinephrine for postoperative bleeding in total joint arthroplasty

Teng

Ma²,

Wang³

et al. 2017

Medicine

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Background:Total joint arthroplasty (TJA) usually results in postoperative bleeding. Some randomized controlled trials (RCTs) and nonrandomized controlled trials (non-RCTs) have been performed to evaluate the effects of epinephrine on postoperative bleeding after TJA. However, this remained controversial about the efficacy and safety of epinephrine for postoperative bleeding in TJA. The objective of our meta-analysis was to compare the overall effect and safety of epinephrine and placebo for postoperative bleeding in TJA.Methods:PubMed, Embase, and the Cochrane Library were searched to identify potentially relevant articles. RCTs or non-RCTs involving epinephrine and placebo for blood loss in total knee arthroplasty or total hip arthroplasty were included. Our study was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. RevMan v5.3 was used to analyze the relevant data.Results:Four RCTs and 1 non-RCT involving 646 participants met the inclusion criteria. The overall pooled results from meta-analysis demonstrated that compared with control groups, epinephrine groups could significantly reduce the postoperative bleeding volume (mean difference [MD] = −168.42, 95% confidence interval [CI]: −272.37 to −64.47, P = 0.001). There was no significant difference in intraoperative bleeding volume between epinephrine and control groups (MD = −12.89, 95% CI: −53.45 to 27.69, P = 0.53). No significant difference was found between 2 groups in terms of postoperative hemoglobin loss (MD = −0.28, 95% CI: −0.66 to 0.10, P = 0.15). Compared with the control groups, no statistically significant difference was found in terms of postoperative transfusion rate in epinephrine groups (relative risk [RR] 0.86, 95% CI: 0.64–1.15, P = 0.31). In addition, the results of the meta-analysis also indicated no significant difference in terms of the incidence rate of deep venous thrombosis (DVT) between 2 groups (RR 0.28, 95% CI: 0.05–1.64, P = 0.16).Conclusion:The meta-analysis showed that epinephrine could significantly reduce postoperative bleeding volume in TJA without increasing the incidence of DVT. However, there was no significant reduction in intraoperative bleeding volume, postoperative hemoglobin loss, and transfusion rate after the administration of epinephrine.Limitations:In this study, a higher heterogeneity and a risk of selection bias may be present in postoperative hemoglobin loss. In addition, the sample size of the included studies was too small, so our findings need to be further validated with more high-quality and larger scale RCTs in the future.Systematic review registration number:None.

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“…If we knew whether these conditions were associated with a high level of sympathetic activation, then we could reach the conclusion that the centrally-mediated splenic contraction is an important source of large platelets, thereby increasing the risk of sudden coronary incidents [71]. In our recent study [75], we found an increase in MPV in response to splenic contraction induced by low dose epinephrine infusion in conditions of decreased blood pressure. Thus, the spleen is a dynamic reservoir of large platelets, the recognized prothrombotic factors.…”

Section: Fainting During Breath-holdmentioning

confidence: 94%

Breath-hold diving as a brain survival response

Dujić

Brešković

Baković

2013

Translational Neuroscience

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Apnea disciplines and current records BREATH HOLD DIVING AS A BRAIN SURVIVAL RESPONSE AbstractElite breath-hold divers are unique athletes challenged with compression induced by hydrostatic pressure and extreme hypoxia/hypercapnia during maximal field dives. The current world records for men are 214 meters for depth (Herbert Nitsch, No-Limits Apnea discipline), 11:35 minutes for duration (Stephane Mifsud, Static Apnea discipline), and 281 meters for distance (Goran Čolak, Dynamic Apnea with Fins discipline). The major physiological adaptations that allow breath-hold divers to achieve such depths and duration are called the "diving response" that is comprised of peripheral vasoconstriction and increased blood pressure, bradycardia, decreased cardiac output, increased cerebral and myocardial blood flow, splenic contraction, and preserved O 2 delivery to the brain and heart. This complex of physiological adaptations is not unique to humans, but can be found in all diving mammals. Despite these profound physiological adaptations, divers may frequently show hypoxic loss of consciousness. The breath-hold starts with an easy-going phase in which respiratory muscles are inactive, whereas during the second so-called "struggle" phase, involuntary breathing movements start. These contractions increase cerebral blood flow by facilitating left stroke volume, cardiac output, and arterial pressure. The analysis of the compensatory mechanisms involved in maximal breath-holds can improve brain survival during conditions involving profound brain hypoperfusion and deoxygenation.

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The effects of low‐dose epinephrine infusion on spleen size, central and hepatic circulation and circulating platelets

Cited by 60 publications

References 41 publications

Mean Platelet Volume (MPV) Predicts Middle Distance Running Performance

Mean Platelet Volume (MPV) Predicts Middle Distance Running Performance

The efficacy and safety of epinephrine for postoperative bleeding in total joint arthroplasty

Breath-hold diving as a brain survival response

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