Thrombin generation and fibrin clot formation under hypothermic conditions: an in vitro evaluation of tissue factor initiated whole blood coagulation

Journal of Critical Care
Matthew F WhelihanKathleen E Brummel-Ziedins

Abstract

Despite trauma-induced hypothermic coagulopathy being familiar in the clinical setting, empirical experimentation concerning this phenomenon is lacking. In this study, we investigated the effects of hypothermia on thrombin generation, clot formation, and global hemostatic functions in an in vitro environment using a whole blood model and thromboelastography, which can recapitulate hypothermia. Blood was collected from healthy individuals through venipuncture and treated with corn trypsin inhibitor, to block the contact pathway. Coagulation was initiated with 5pM tissue factor at temperatures 37°C, 32°C, and 27°C. Reactions were quenched over time, with soluble and insoluble components analyzed for thrombin generation, fibrinogen consumption, factor (f)XIII activation, and fibrin deposition. Global coagulation potential was evaluated through thromboelastography. Data showed that thrombin generation in samples at 37°C and 32°C had comparable rates, whereas 27°C had a much lower rate (39.2 ± 1.1 and 43 ± 2.4 nM/min vs 28.6 ± 4.4 nM/min, respectively). Fibrinogen consumption and fXIII activation were highest at 37°C, followed by 32°C and 27°C. Fibrin formation as seen through clot weights also followed this trend. Thromboelastograp...Continue Reading

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Citations

Oct 7, 2015·Anesthesia and Analgesia·Matthew James LawrencePhillip Adrian Evans
Nov 18, 2015·Therapeutic Hypothermia and Temperature Management·Amanda R StahlKelly N Sawyer
May 1, 2016·Critical Care : the Official Journal of the Critical Care Forum·Anni Nørgaard JeppesenAnne Mette Hvas
May 24, 2017·Artificial Cells, Nanomedicine, and Biotechnology·Yuchen HuangWei Xue
Feb 7, 2021·Journal of the American College of Surgeons·Julia R ColemanSaulius Butenas
Apr 18, 2021·The Journal of Thoracic and Cardiovascular Surgery·Abe DeAnda, Sean G Yates
May 12, 2021·Journal of Biomedical Materials Research. Part a·Jarel K GandhiAlan D Marmorstein

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