THE DISPARITY BETWEEN HYPOTHERMIC COAGULOPATHY AND CLOTTING STUDIES
THE DISPARITY BETWEEN HYPOTHERMIC COAGULOPATHY AND CLOTTING STUDIES
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DOI：
10.1097/00005373-199209000-00022
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发表时间：
1992-09-01
影响因子：
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通讯作者：
FISCHER, RP
中科院分区：
文献类型：
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作者：
REED, RL;JOHNSTON, TD;FISCHER, RP
低温患者通常会出现凝血功能障碍，但低温对凝血功能的影响尚不清楚，因为临床实验室通常只在37℃下进行凝血试验。测量活化的部分凝血活素时间（APTT）、凝血酶原时间（PT）和凝血酶时间（TT）在常温和低温大鼠的血浆中进行，以评估低温对凝血因子水平和凝血因子活性的影响。一般来说，当测试温度较低时，凝血时间比体温较低时延长得更严重。事实上，仅仅由于体温过低而导致的延长几乎没有。这些发现揭示了临床明显的低温凝血病和接近正常的凝血研究之间的差异。在37摄氏度下进行的凝血研究不能证实低体温凝血病。这些结果表明，低温诱导的凝血功能障碍的适当治疗是重新加热而不是使用凝血因子。
Hypothermic patients commonly develop coagulopathy, but the effects of hypothermia on coagulation remain unclear because clinical laboratories routinely perform clotting tests only at 37-degrees-C. Measurements of activated partial thromboplastin times (APTT), prothrombin times (PT), and thrombin times (TT) were performed on plasma from normothermic and hypothermic rats at a range of temperatures (25-degrees-37-degrees-C) to assess the effects of hypothermia on apparent clotting factor levels and clotting factor activities. In general, clotting times were more severely prolonged when test temperatures were hypothermic than when body temperatures were hypothermic. Indeed, little to no prolongation resulted from body hypothermia alone. These findings reveal the observed disparity between clinically evident hypothermic coagulopathy and near-normal clotting studies. Clotting studies performed at 37-degrees-C will not confirm hypothermic coagulopathy. These results indicate that the appropriate treatment for hypothermia-induced coagulopathy is rewarming rather than administration of clotting factors.