Preview

Yakut Medical Journal

Advanced search

Study of coagulation hemostasis in rats under conditions of induced general moderate hypothermia

https://doi.org/10.25789/YMJ.2025.89.07

Abstract

The use of induced hypothermia in clinical practice can lead to coagulopathy, increasing the risk of peri- and postoperative bleeding. The aim of this study was to investigate the effect of cooling the body to moderate hypothermia on the hemostatic system in rats. Activated partial thromboplastin time (APTT), thrombin time (TT), and prothrombin time (PT) were determined upon reaching a rectal temperature of 32°C and after prolonged two-hour hypothermia while maintaining the animal’s temperature at the same level. It was shown that cooling the animals to moderate hypothermia resulted in an increase in activated partial thromboplastin time, thrombin time, and prothrombin time, indicating the development of hypocoagulation shifts and impairment of the secondary hemostasis. With prolonged hypothermic exposure, a decrease in APTT, TT, and PT parameters from the achieved values was observed, which probably indicates some suppression of coagulation reactions with prolonged exposure to moderate hypothermia. It is suggested that impaired thrombin generation may be a key factor in hypothermia-induced coagulopathy.

About the Author

N. N. Melnikova
Институт физиологии им. И.П. Павлова РАН
Russian Federation


References

1. The influence of temperature on platelet hemostasis induced by various agonists / Dobrylko I.A., Volkova A.A., Gerda B.A. [et al.] // Pediatric Hematology/Oncology and Immunopathology. 2024. No. 23(1). P. 92-98.

2. Kuznik B.I. Cellular and molecular mechanisms of regulation of the hemostasis system in norm and pathology. Chita: Express Publishing House, 2010. 832 p.

3. Laboratory methods for studying the blood coagulation system: Methodical recommendations of the A.Schmidt-B.A.Kudryashov Russ Acc. Of Thrombosis, Hemorrhages and Vascular Pathology. Edited by I.N. Bokarev. 2nd edition. Moscow, 2011.

4. Lycheva N.A., Shakhmatov I.I., Kiselev V.I. Influence of cooling medium on rat hemostatic system // Bulletin of Siberian Medicine. 2017. No. 16(1). P. 50-58.

5. Nazarova I.A., Lycheva N.A., Tomilova I.N. Deep hypothermia and its effect on the hemostasis system of rats // Works of young scientists of AGMU. 2017. No. 14. P. 12-15.

6. Structural and morphological features of vascular changes under conditions of hypothermic injury / Bondarenko D.N., Korsikov N.A., Lepilov A.V. [et al]. // Scientist. 2023. No. 4(26). P. 6-14.

7. Chudakov A.Yu. On the effect of cold on blood // J Vector of Sci Thought. 2023. No. 4(4). P. 105-128.

8. Shakhmatov I.I., Kiselev V.I. Universal mechanisms of response of the hemostasis system to the action of various stressors // Bulletin of Medical Science. 2017. No. 1(5). P. 14-19.

9. Wolberg A.S., Meng Z.H., Monroe D.M., Hoffman. A systematic evaluation of the effect of temperature on coagulation enzyme activity and platelet function // J Trauma. 2004. No. 56(6). P. 1221-1228. doi: 10.1097/01.ta.0000064328.97941.fc.

10. Accidental hypothermia: 2021 update / Paal P., Pasquier M., Darocha T. [et al.] // International Journal of Environmental Research and Public Health. 2022. No. 19(1). P. 501. doi: 10.3390/ijerph19010501.

11. Adaptation of global hemostasis to therapeutic hypothermia in patients with out-of-hospital cardiac arrest: Thromboelastography study / Trąbka-Zawicki A., Tomala M., Zeliaś A. [et al.] // Cardiol J. 2019. No. 26(1). P. 77-86. doi: 10.5603/CJ.a2017.0080.

12. Cerebral protection strategies in aortic arch surgery-past developments, current evidence, and future innovation / Werner P., Winter M., Mahr S. [et al.] // Bioengineering (Basel). 2024. No. 11(8). P. 775. doi: 10.3390/bioengineering11080775.

13. Coagulation under mild hypothermia assessed by thromboelastometry / Nitschke T., Groene P., Acevedo A.C. [et al.] // Transfus Med

14. Hemother. 2021. No. 48(4). P. 203-209. doi: 10.1159/000513922.

15. Current advances in the use of therapeutic hypothermia / Lundbye J., Badjatia N., Polderman K.H., Lyden P. // Ther Hypothermia Temp Manag. 2020. No. 10(1). P. 2-5. doi: 10.1089/ther.2019.29070.jjl.

16. Li Z., Ji X., Zheng T., Zhang Y., Li Z. Effect of long-term and short-term mild hypothermia in severe traumatic brain injury: a comparative study // Chinese Intensive Care Medicine. 2019. No. 31(12). P. 1440-1444. doi: 10.3760/cma.j.issn.2095-4352.2019.12.002.

17. Hypothermic anticoagulation: testing individual responses to graded severe hypothermia with thromboelastography / Ruzicka J., Stengl M., Bolek L. [et al.] // Blood Coagul Fibrinolysis. 2012. No. 23(4). P. 285-289. doi: 10.1097/MBC.0b013e328351885a.

18. Induced hypothermia does not impair coagulation system in a swine multiple trauma model / Mohr J., Ruchholtz S., Hildebrand F. [et al.] // J Trauma Acute Care Surg. 2013. No. 74. P. 1014–1020. doi: 10.1097/TA.0b013e3182826edd.

19. Ipekci A., Cakmak F. Hypothermia // Cerrahpasa Medical Journal. 2023. No. 47(S1). P. 27-32. doi: 10.5152/cjm.2023.23025.

20. Kander Th., Schött U. Effect of hypothermia on haemostasis and bleeding risk: a narrative review // Journal of International Medical Research. 2019. No. 47. P. 3559-3568. doi: 10.1177/0300060519861469.

21. Martini W.Z. The effects of hypothermia on fibrinogen metabolism and coagulation function in swine // Metabolism. 2007. No. 56(2). P. 214-221. doi: 10.1016/j.metabol.2006.09.015.

22. Scharbert G., Kalb M.L., Essmeister R., Kozek-Langenecker S.A. Mild and moderate hypothermia increases platelet aggregation induced by various agonists: a whole blood in vitro study // Platelets. 2010. No. 21(1). P. 44-48. doi: 10.3109/09537100903420269.

23. Mitrophanov A.Y., Rosendaal F.R., Reifman J. Computational analysis of the effects of reduced temperature on thrombin generation: the contributions of hypothermia to coagulopathy // Anesth Analg. 2013. No. 117(3). P. 565-574. doi: 10.1213/ANE.0b013e31829c3b22.

24. Model of trauma-induced coagulopathy including hemodilution, fibrinolysis, acidosis, and hypothermia: Impact on blood coagulation and platelet function / Shenkman B., Budnik I., Einav Y. [et al.] // J Trauma Acute Care Surg. 2017. No. 82(2). P. 287-292. doi: 10.1097/TA.0000000000001282.

25. Park K.H., Lee K.H., Kim H. Effect of hypothermia on coagulatory function and survival in Sprague–Dawley rats exposed to uncontrolled haemorrhagic shock // Injury. 2013. No. 44. P. 91-96. doi: 10.1016/j.injury.2011.11.016.

26. Part 1: executive summary: 2020 American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care / Merchant R.M., Topjian A.A., Panchal A.R. [et al.] // Circulation. 2020. No. 142(16, S2). P. S337–357. doi: 10.1161/CIR.0000000000000918.

27. Physiological changes in subjects exposed to accidental hypothermia: an update / Bjertnæs L.J., Næsheim T.O., Reierth E. [et al.] // Front Med (Lausanne). 2022. No 9:824395. doi: 10.3389/fmed.2022.824395.

28. Kander T., Dankiewicz J., Friberg H., Schött U. Platelet aggregation and clot formation in comatose survivors of cardiac arrest treated with induced hypothermia and dual platelet inhibition with aspirin and ticagrelor; a prospective observational study // Crit Care. 2014. No. 18(5). P. 495. doi: 10.1186/s13054-014-0495-z.

29. Polderman K.H. Hypothermia and coagulation // Crit Care Med. 2012. No. 16 (S2). P. A20. doi: 10.1186/cc11278.

30. Polderman K.H. Mechanisms of action, physiological effects, and complications of hypothermia // Crit Care Med. 2009. No. 37(S7). P. S186-202. doi: 10.1097/CCM.0b013e3181aa5241.

31. Hui S., Zhang Q., Lang J., Yi J. Temperature effect on coagulation function in mild hypothermic patients undergoing thoracic surgeries: thromboelastography (TEG) versus standard tests // Perioper Med (Lond). 2024. No. 13(1). P. 55. doi: 10.1186/s13741-024-00405-8.

32. Li L., Chen X., Ma W., Li Y. The effects of hypothermia in thrombosis: a systematic review and meta-analysis // Ann Palliat Med. 2021. P. 1925. doi: 10.21037/apm-21-1925.

33. The effects of mild hypothermia on coagulation tests and haemodynamic variables in anaesthetized rabbits / Staikou C., Paraskeval A., Donta I. [et al.] // West Indian Med J. 2011. No. 60(5). P. 513-518.

34. The influence of induced hypothermia for hemostatic function on temperature-adjusted measurements in rabbits / Shimokawa M., Kitaguchi K., Kawaguchi M. [et al.] // Anesth Analg. 2003. No. 96(4). P. 1209-1213. doi: 10.1213/01.ANE.0000050767.86196.AF.

35. Quine E.J., Murray L., Trapani T., Cooper D.J. Thromboelastography to assess coagulopathy in traumatic brain injury patients undergoing therapeutic hypothermia // Ther Hypothermia Temp Manag. 2021. No. 11(1). P. 53-57. doi: 10.1089/ther.2020.0025.

36. Whelihan M.F., Kiankhooy A., Brummel-Ziedins K.E. Thrombin generation and fibrin clot formation under hypothermic conditions: an in vitro evaluation of tissue factor initiated whole blood coagulation // J Crit Care. 2014. No. 29(1). P. 24-30. doi: 10.1016/j.jcrc.2013.10.010.


Review

For citations:


Melnikova N.N. Study of coagulation hemostasis in rats under conditions of induced general moderate hypothermia. Yakut Medical Journal. 2025;(1):27-31. https://doi.org/10.25789/YMJ.2025.89.07

Views: 65


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1813-1905 (Print)
ISSN 2312-1017 (Online)