Thromboelastographic Study of Psychophysiological Stress

Peng, Henry T.; Rhind, Shawn G.

doi:10.1177/1076029613512415

Cited by 9 publications

(10 citation statements)

References 127 publications

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“…Both physical activity and psychological stress have been investigated for their effects on blood coagulation and fibrinolysis, 28,29 and both TEG and ROTEM have been used in such studies. 30 Coagulation defect is one of the main causes of decompression sickness. Decompression causes upregulation of both the coagulant and fibrinolysis pathways, however, its overall effects are not well studied.…”

Section: Discussionmentioning

confidence: 99%

Effects of Hyperbaric and Decompression Stress on Blood Coagulation and Fibrinolysis

Peng

Cameron

Rhind

2015

Clin Appl Thromb Hemost

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Hyperbaric and decompression stress from diving impairs blood coagulation and fibrinolysis. We hypothesized that thromboelastography (TEG) and rotational thromboelastometry (ROTEM) were suitable to characterize the effects of stress on global hemostatic profiles. We thus conducted a comparative study of the hyperbaric effects on human coagulation using TEG and ROTEM. Maximum clot strength (maximum amplitude [MA]) and clot lysis (lysis index at time 30 minutes [LI30]) were reduced as indicated by TEG MA and EXTEM LI30, respectively. The relative changes in coagulation and fibrinolysis by the hyperbaric effects of diving were indicated by reduced TEG reaction time R at 5 hours, MA at 24 hours postdive, and reduced EXTEM coagulation time at 15 minutes postdive as well as decreased fibrinolysis (EXTEM LI30) at all postdiving time points investigated. Comparison of the parameter values and the diving-induced changes in each parameter between TEG and ROTEM showed both differences and correlations. The discrepancies between the 2 systems may be due to the different assay reagents used. Future studies will seek to further elucidate the changes in blood coagulation and fibrinolysis following varying levels of hyperbaric and decompression stress.

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Section: Discussionmentioning

confidence: 99%

Effects of Hyperbaric and Decompression Stress on Blood Coagulation and Fibrinolysis

Peng

Cameron

Rhind

2015

Clin Appl Thromb Hemost

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“…A lower percentage tPA‐induced clot lysis was observed post‐smoking . Effects of stress on thromboelastographic outcomes were extensively reviewed by Peng and Rhind . Most relevant to blood donors is physiological stress by exercise, temperature extremes or psychological stress due to the blood donation procedure.…”

Section: Healthy Volunteers and Blood Donorsmentioning

confidence: 99%

“…Most relevant to blood donors is physiological stress by exercise, temperature extremes or psychological stress due to the blood donation procedure. In general, physiological stress gives a hypercoagulable response, and also activation of fibrinolysis as the intensity of exercise increases . In thromboelastography, stepwise lowering of temperature from 38°C to 32°C resulted in stronger clots at low temperature, but longer initiation times .…”

Section: Healthy Volunteers and Blood Donorsmentioning

confidence: 99%

Thromboelastography as a tool to evaluate blood of healthy volunteers and blood component quality: a review

2019

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Thromboelastography is a technique to evaluate the overall coagulation behaviour of blood and blood components. First, we evaluated the literature concerning the use of thromboelastography for characterizing coagulation behaviour of healthy volunteers, such as blood donors. Overall coagulation is sensitive to gender, most likely caused by the difference in haematocrit and plasma content of male versus female blood. Smaller and less pronounced effects in thromboelastographic response are caused by differences in fibrinogen level or by use of oral contraceptives. Short‐term hypercoagulable effects are observed after smoking or blood donation, while small effects of non‐steroidal anti‐inflammatory drugs on platelets are also present. Second, in whole blood donations, the thromboelastographic variables are also sensitive to storage time and temperature, but are less sensitive to levels of clotting factors. Platelet count and quality have little influence on thromboelastographic variables, and differences are mainly observed at counts <100x109/l, after extended storage time of platelet concentrates or storage under specific conditions, including freezing. Thromboelastographic profiles of plasma samples are mainly affected by residual cell counts, microparticles and fibrinogen levels, and less by levels of clotting factors. Taken together, publications have shown that as an overall clotting test, thromboelastography may support optimization of blood component preparation and storage with regard to temperature, time and secondary and tertiary treatments. Minimal deviations of in vitro quality are most reliable demonstrated when an appropriate assay is chosen.

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“…These settings include cardiac surgery [67–70], liver transplantations [71], sepsis [72], trauma [73–79], obstetrics [80], psychophysiological stress [81]. These systems have also been utilized to evaluate anticoagulant activity [82, 83] and determine what the critical threshold value is for the initiation of antifibrinolytic therapy in trauma [84].…”

Section: Thrombin Generation Assaysmentioning

confidence: 99%

Global assays of hemostasis

Brummel‐Ziedins

Wolberg

2014

Current Opinion in Hematology

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Purpose of review There exists an imbalance between our understanding of the physiology of the blood coagulation process and the translation of this understanding into useful assays for clinical application. As technology advances, the capabilities for merging the two areas have become more attainable. Global assays have advanced our understanding of the dynamics of the blood coagulation process beyond end point assays and are at the forefront of implementation in the clinic. Recent findings We will review recent advances in the main global assays with a focus on thrombin generation that have potential for clinical utility. These assays include direct (thrombogram, whole blood, purified systems) and indirect empirical measures of thrombin generation (thromboelastography) and mechanism-based computational models that use plasma composition data from individuals to generate thrombin generation profiles. Summary Empirical thrombin generation assays (direct and indirect) and computational modeling of thrombin generation have greatly advanced our understanding of the hemostatic balance. Implementation of these types of assays and visualization approaches in the clinic potentially will provide a basis for the development of individualized patient care. Advances in both empirical and computational global assays have made the goal of predicting pre-crisis changes in an individual’s hemostatic state one step closer.

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Thromboelastographic Study of Psychophysiological Stress

Cited by 9 publications

References 127 publications

Effects of Hyperbaric and Decompression Stress on Blood Coagulation and Fibrinolysis

Effects of Hyperbaric and Decompression Stress on Blood Coagulation and Fibrinolysis

Thromboelastography as a tool to evaluate blood of healthy volunteers and blood component quality: a review

Global assays of hemostasis

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