Effect of hypothermia on the coagulation cascade.

Abstract:

BACKGROUND AND METHODS:The development of a multifactorial coagulopathy after massive transfusion is a well-recognized clinical problem that is almost always accompanied by hypothermia. The purpose of this study was to investigate the isolated effect of alterations of temperature on the integrity of the coagulation cascade. Prothrombin times and partial thromboplastin times were each performed 15 times on samples of pooled normal plasma at the temperatures of 37 degrees C, 34 degrees C, 31 degrees C, and 28 degrees C, as well as 39 degrees C and 41 degrees C. RESULTS:Mean prothrombin time results increased from 11.8 +/- 0.3 (SD) secs at 37 degrees C to 12.9 +/- 0.5, 14.2 +/- 0.5, and 16.6 +/- 0.2 secs at 34 degrees C, 31 degrees C, and 28 degrees C, respectively (p < or = .001 for each). Partial thromboplastin time determinations increased from 36.0 +/- 0.7 (SD) secs at 37 degrees C to 39.4 +/- 1.0, 46.1 +/- 1.1, and 57.2 +/- 0.6 secs at 34 degrees C, 31 degrees C, and 28 degrees C, respectively (p < or = .001 for each). Both prothrombin time and partial thromboplastin time determinations were only minimally shortened at hyperthermic temperatures. CONCLUSIONS:The series of enzymatic reactions of the coagulation cascade are strongly inhibited by hypothermia, as demonstrated by the dramatic prolongation of prothrombin time and partial thromboplastin time tests at hypothermic deviations from normal temperature in a situation where factor levels were all known to be normal. Clinicians who deal with critically ill massively transfused hypothermic patients all recognize the inevitable appearance of a coagulopathy that has a multifactorial origin. Unless specifically considered, the contribution of hypothermia to the hemorrhagic diathesis may be overlooked since coagulation testing is performed at 37 degrees C, rather than at the patient's actual in vivo temperature.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Rohrer MJ,Natale AM

doi

10.1097/00003246-199210000-00007

subject

Has Abstract

pub_date

1992-10-01 00:00:00

pages

1402-5

issue

10

eissn

0090-3493

issn

1530-0293

journal_volume

20

pub_type

杂志文章
  • Effects of Different Doses of Remote Ischemic Preconditioning on Kidney Damage Among Patients Undergoing Cardiac Surgery: A Single-Center Mechanistic Randomized Controlled Trial.

    abstract:OBJECTIVES:We have previously shown that remote ischemic preconditioning reduces acute kidney injury (acute kidney injury) in high-risk patients undergoing cardiopulmonary bypass and that the protective effect is confined to patients who exhibit an increased urinary tissue inhibitor of metalloproteinases-2 and insulin-...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000004415

    authors: Meersch M,Küllmar M,Pavenstädt H,Rossaint J,Kellum JA,Martens S,Klausmeyer P,Schmidt EA,Kerschke L,Zarbock A

    更新日期:2020-08-01 00:00:00

  • Lithium dilution cardiac output measurement: a comparison with thermodilution.

    abstract:OBJECTIVE:To compare the results of cardiac output measurements obtained by lithium dilution and thermodilution. DESIGN:Case series, observational study. SETTING:High-dependency postoperative unit and intensive care unit of a teaching hospital. PATIENTS:Forty patients were studied. Thirty-four patients had undergoin...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1097/00003246-199711000-00015

    authors: Linton R,Band D,O'Brien T,Jonas M,Leach R

    更新日期:1997-11-01 00:00:00

  • Perceptions of a critically ill patient experiencing therapeutic paralysis in an ICU.

    abstract::Prolonged therapeutic paralysis with pancuronium is commonly used in ICUs to facilitate mechanical ventilation of patients with respiratory failure. Sedation is usually given concomitantly to reduce patient discomfort, but assessment of its adequacy is made difficult by the paralysis. We recently cared for a former IC...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198401000-00018

    authors: Parker MM,Schubert W,Shelhamer JH,Parrillo JE

    更新日期:1984-01-01 00:00:00

  • Chloride Content of Fluids Used for Large-Volume Resuscitation Is Associated With Reduced Survival.

    abstract:OBJECTIVE:We sought to investigate if the chloride content of fluids used in resuscitation was associated with short- and long-term outcomes. DESIGN:We identified patients who received large-volume fluid resuscitation, defined as greater than 60 mL/kg over a 24-hour period. Chloride load was determined for each patien...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000002063

    authors: Sen A,Keener CM,Sileanu FE,Foldes E,Clermont G,Murugan R,Kellum JA

    更新日期:2017-02-01 00:00:00

  • Randomized ICU trials do not demonstrate an association between interventions that reduce delirium duration and short-term mortality: a systematic review and meta-analysis.

    abstract:OBJECTIVES:We reviewed randomized trials of adult ICU patients of interventions hypothesized to reduce delirium burden to determine whether interventions that are more effective at reducing delirium duration are associated with a reduction in short-term mortality. DATA SOURCES:We searched CINHAHL, EMBASE, MEDLINE, and...

    journal_title:Critical care medicine

    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/CCM.0000000000000224

    authors: Al-Qadheeb NS,Balk EM,Fraser GL,Skrobik Y,Riker RR,Kress JP,Whitehead S,Devlin JW

    更新日期:2014-06-01 00:00:00

  • Quality of life among long-term survivors of intensive care.

    abstract::Quality of life was examined in 717 individuals 1 yr after their admission to a multidisciplinary ICU. Of these, 87% were able to live at home 6 months after their admission. Of patients 65 yr and older, 90% had been living independently before admission compared to 80% 1 yr afterward. Of those younger than 65 yr, mos...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198708000-00006

    authors: Zarén B,Hedstrand U

    更新日期:1987-08-01 00:00:00

  • Total electrical power failure in a cardiothoracic intensive care unit.

    abstract:OBJECTIVE:To describe the management of patients in an ICU during failure of both primary and backup electrical systems, resulting in nonfunctioning monitors, mechanical ventilators, and other life-support equipment. DESIGN:Case report of power outage and discussion. SETTING:A 45-bed cardiothoracic surgical ICU in a ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199206000-00023

    authors: O'Hara JF Jr,Higgins TL

    更新日期:1992-06-01 00:00:00

  • Sirtuin 1 Stimulation Attenuates Ischemic Liver Injury and Enhances Mitochondrial Recovery and Autophagy.

    abstract:OBJECTIVES:Hepatic ischemia-reperfusion is a major clinical problem with limited treatment options. The pathophysiology of hepatic ischemia-reperfusion is characterized by mitochondrial dysfunction and cellular energy deficits. Sirtuin 1 is an energy-sensing enzyme known to modulate mitochondrial biogenesis. We hypothe...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000001637

    authors: Khader A,Yang WL,Godwin A,Prince JM,Nicastro JM,Coppa GF,Wang P

    更新日期:2016-08-01 00:00:00

  • Early cerebral prognosis of anoxic encephalopathy using brain energy metabolism.

    abstract::Cerebral arteriovenous differences in oxygen content [C(a-v)O2] and glucose content [C(a-v)gluc] were used to predict outcome in 20 patients who remained comatose after resuscitation for cardiopulmonary arrest. Cerebral prognosis was good when C(a-v)O2 values were greater than 1.8 mMol/L and the oxygen glucose index (...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198410000-00013

    authors: Ducassé JL,Marc-Vergnes JP,Cathala B,Genestal M,Lareng L

    更新日期:1984-10-01 00:00:00

  • Assessment of the development of choked flow during total liquid ventilation.

    abstract:OBJECTIVE:The flow rate of a liquid drainage from the lungs is limited because of the elastic nature of the airways. This study was designed to clarify the relationship between intrapulmonary liquid volume and the development of the flow limitation or choked flow phenomenon as a function of expiratory flow rate during ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000104918.48411.91

    authors: Baba Y,Brant D,Brah SS,Grotberg J,Bartlett RH,Hirschl RB

    更新日期:2004-01-01 00:00:00

  • Acute hypercapnia increases the oxygen-carrying capacity of the blood in ventilated dogs.

    abstract:OBJECTIVE:To test the hypothesis that PaCO2 levels generated during permissive hypercapnia may enhance arterial oxygenation, when ventilation is maintained. DESIGN:Prospective study. SETTING:Research laboratory in a hospital. SUBJECTS:One group of eight mongrel dogs (four male; four female). INTERVENTIONS:The dogs ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199811000-00030

    authors: Torbati D,Mangino MJ,Garcia E,Estrada M,Totapally BR,Wolfsdorf J

    更新日期:1998-11-01 00:00:00

  • Continuous Versus Intermittent Infusion of Vancomycin and the Risk of Acute Kidney Injury in Critically Ill Adults: A Systematic Review and Meta-Analysis.

    abstract:OBJECTIVES:Critically ill patients routinely receive vancomycin as empiric antibiotic therapy. A continuous infusion administration strategy may be superior to intermittent infusion by minimizing peak concentrations and variability thereby optimizing safety. We performed a systematic review and meta-analysis to investi...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000004326

    authors: Flannery AH,Bissell BD,Bastin MT,Morris PE,Neyra JA

    更新日期:2020-06-01 00:00:00

  • Sex-based differences in serum cardiac troponin I, a specific marker for myocardial injury, after cardiac surgery.

    abstract:BACKGROUND:Prevalence and causes of sex-based differences in morbidity and mortality secondary to cardiovascular disease remain controversial. Cardiac troponin I (cTnI) is a sensitive and specific marker for myocardial injury. Serial cTnI measurements have been used to identify perioperative myocardial cell injury. OB...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000055442.84685.4D

    authors: Schwarzenberger JC,Sun LS,Pesce MA,Heyer EJ,Delphin E,Almeida GM,Wood M

    更新日期:2003-03-01 00:00:00

  • Targeted temperature management processes and outcomes after out-of-hospital cardiac arrest: an observational cohort study*.

    abstract:OBJECTIVES:Targeted temperature management has been shown to improve survival with good neurological outcome in patients after out-of-hospital cardiac arrest. The optimal approach to inducing and maintaining targeted temperature management, however, remains uncertain. The objective of this study was to evaluate these p...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/CCM.0000000000000551

    authors: Lin S,Scales DC,Dorian P,Kiss A,Common MR,Brooks SC,Goodman SG,Salciccioli JD,Morrison LJ

    更新日期:2014-12-01 00:00:00

  • Microvascular and systemic effects following top load administration of saturated carbon monoxide-saline solution.

    abstract:OBJECTIVE:To determine how top loads with different doses of carbon monoxide (CO)-saturated saline solutions (CO-saline) affect microvascular and systemic hemodynamics and to delineate the corresponding biochemical mechanisms. DESIGN:Prospective study. SETTING:University research laboratory. SUBJECTS:Male Golden Syr...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000259533.84180.C7

    authors: Hangai-Hoger N,Tsai AG,Cabrales P,Suematsu M,Intaglietta M

    更新日期:2007-04-01 00:00:00

  • Association Between Critical Care Admissions and Cognitive Trajectories in Older Adults.

    abstract:OBJECTIVES:Patients requiring admission to an ICU may subsequently experience cognitive decline. Our objective was to investigate longitudinal cognitive trajectories in older adults hospitalized in ICUs. We hypothesized that individuals hospitalized for critical illness develop greater cognitive decline compared with t...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000003829

    authors: Schulte PJ,Warner DO,Martin DP,Deljou A,Mielke MM,Knopman DS,Petersen RC,Weingarten TN,Warner MA,Rabinstein AA,Hanson AC,Schroeder DR,Sprung J

    更新日期:2019-08-01 00:00:00

  • Evaluating laboratory usage in the intensive care unit: patient and institutional characteristics that influence frequency of blood sampling.

    abstract:OBJECTIVES:To develop a predictive equation to estimate the frequency of blood drawing for intensive care unit (ICU) laboratory tests and to evaluate variations in ICU blood sampling practices after adjusting for patient and institutional factors. DESIGN:Prospective, inception, cohort study. SETTING:Forty-two ICUs in...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/00003246-199705000-00006

    authors: Zimmerman JE,Seneff MG,Sun X,Wagner DP,Knaus WA

    更新日期:1997-05-01 00:00:00

  • Multicenter study of oxygen-insensitive handheld glucose point-of-care testing in critical care/hospital/ambulatory patients in the United States and Canada.

    abstract:OBJECTIVES:Existing handheld glucose meters are glucose oxidase (GO)-based. Oxygen side reactions can introduce oxygen dependency, increase potential error, and limit clinical use. Our primary objectives were to: a) introduce a new glucose dehydrogenase (GD)-based electrochemical biosensor for point-of-care testing; b)...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/00003246-199803000-00036

    authors: Kost GJ,Vu HT,Lee JH,Bourgeois P,Kiechle FL,Martin C,Miller SS,Okorodudu AO,Podczasy JJ,Webster R,Whitlow KJ

    更新日期:1998-03-01 00:00:00

  • Increased intracellular cyclic adenosine 3', 5'-monophosphate inhibits release of tumor necrosis factor-alpha from human vascular tissue and cultured smooth muscle cells.

    abstract:OBJECTIVES:We recently reported that bacterial lipopolysaccharide stimulates release of tumor necrosis factor (TNF)-alpha from both human vascular tissue and cultured smooth muscle cells. In the current study, we tested the hypothesis that increased intracellular cyclic adenosine 3',5'-monophosphate (cAMP) could inhibi...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199711000-00025

    authors: Zhang LM,Castresana MR,Shaker IJ,Dalton ML,Leeper-Woodford SK,Newman WH

    更新日期:1997-11-01 00:00:00

  • Effect of enriched thioglycolate on direct examination of respiratory specimens and guiding initial empirical therapy in intubated patients with pneumonia: a prospective, randomized study.

    abstract:OBJECTIVE:To evaluate the use of enriched thioglycolate as a transport medium of protected specimen brush samples, in particular its value in direct examination of respiratory specimens and in guiding initial antibiotic prescription. DESIGN:Prospective, randomized, pilot study. SETTING:Medical-surgical teaching inten...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00003246-200202000-00008

    authors: Rello J,Mariscal D,Gallego M,Valles J

    更新日期:2002-02-01 00:00:00

  • Reliability and accuracy of Sequential Organ Failure Assessment (SOFA) scoring.

    abstract:OBJECTIVE:The Sequential Organ Failure Assessment (SOFA) score was developed to quantify the severity of patients' illness, based on the degree of organ dysfunction. This study aimed to evaluate the accuracy and the reliability of SOFA scoring. DESIGN:Prospective study. SETTING:Adult intensive care unit (ICU) in a te...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/01.ccm.0000178178.02574.ab

    authors: Arts DG,de Keizer NF,Vroom MB,de Jonge E

    更新日期:2005-09-01 00:00:00

  • Occurrence of nosocomial pneumonia in mechanically ventilated trauma patients: a comparison of sucralfate and ranitidine.

    abstract:OBJECTIVE:To determine if there is a difference in nosocomial pneumonia frequency rate in mechanically ventilated trauma patients treated with sucralfate vs. ranitidine for stress ulcer prophylaxis. DESIGN:Prospective, randomized trial. SETTING:A 640-bed urban teaching hospital and trauma center. PATIENTS:Ninety-two...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00003246-199312000-00012

    authors: Pickworth KK,Falcone RE,Hoogeboom JE,Santanello SA

    更新日期:1993-12-01 00:00:00

  • ST changes during sodium nitroprusside therapy in acute myocardial infarction.

    abstract::Nineteen patients with acute anterior myocardial infarction who were hypertensive (systolic BP greater than or equal to 170 mm Hg and/or diastolic BP greater than or equal to 100 mm Hg) at the time of admission were treated with continuous infusion of sodium nitroprusside (NP). The administration of NP resulted in a s...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198310000-00010

    authors: Rucabado L,Miñana J,Cebrián J,Monsalve F,Cuñat J,Ruano M

    更新日期:1983-10-01 00:00:00

  • Increased nuclear factor kappa B activation in critically ill patients who die.

    abstract:OBJECTIVES:To determine nuclear factor kappa B (NF-kappa B) activation in mononuclear and neutrophils from critically ill patients and to compare NF-kappa B activation with circulating concentrations of interleukin (IL)-6, IL-8, and soluble intercellular adhesion molecule (sICAM)-1. DESIGN:Observational study. SETTIN...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200004000-00022

    authors: Paterson RL,Galley HF,Dhillon JK,Webster NR

    更新日期:2000-04-01 00:00:00

  • The Duffy antigen receptor for chemokines in acute renal failure: A facilitator of renal chemokine presentation.

    abstract:OBJECTIVE:Acute renal failure remains a major challenge in critical care medicine. Both neutrophils and chemokines have been proposed as key components in the development of acute renal failure. Although the Duffy antigen receptor for chemokines (DARC) is present in several tissues and a highly specific ligand for vari...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.ccm.0000280570.82885.32

    authors: Zarbock A,Schmolke M,Bockhorn SG,Scharte M,Buschmann K,Ley K,Singbartl K

    更新日期:2007-09-01 00:00:00

  • Effects of epinephrine, norepinephrine, or the combination of norepinephrine and dobutamine on gastric mucosa in septic shock.

    abstract:OBJECTIVES:To compare in the same patient with septic shock, respective effects of epinephrine, norepinephrine, and the combination of norepinephrine and dobutamine (5 microg/kg/min) on systemic hemodynamic parameters and gastric mucosal perfusion using gastric tonometry and laser-Doppler flowmetry techniques. DESIGN:...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00003246-199905000-00021

    authors: Duranteau J,Sitbon P,Teboul JL,Vicaut E,Anguel N,Richard C,Samii K

    更新日期:1999-05-01 00:00:00

  • High-dose exogenous iron following cecal ligation and puncture increases mortality rate in mice and is associated with an increase in gut epithelial and splenic apoptosis.

    abstract:OBJECTIVES:Despite having dysregulated iron metabolism, critically ill patients may receive exogenous iron for the treatment of anemia. Iron is associated with increased tissue apoptosis and may facilitate bacterial growth. We hypothesized that exogenous iron administration given after the onset of sepsis would lead to...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.ccm.0000124878.02614.4c

    authors: Javadi P,Buchman TG,Stromberg PE,Husain KD,Dunne WM,Woolsey CA,Turnbull IR,Hotchkiss RS,Karl IE,Coopersmith CM

    更新日期:2004-05-01 00:00:00

  • High permeability dialysis membrane allows effective removal of myoglobin in acute kidney injury resulting from rhabdomyolysis.

    abstract:OBJECTIVE:The objective of this study was to test the ability of myoglobin removal of a novel, high-permeability polysulphone dialyzer in acute kidney injury as a result of rhabdomyolysis. SETTING:Intensive care unit of a tertiary care hospital. PATIENTS:Six patients (one female; aged 24, 36, 41, 55, 63, and 65 yrs) ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3181feb7f0

    authors: Sorrentino SA,Kielstein JT,Lukasz A,Sorrentino JN,Gohrbandt B,Haller H,Schmidt BM

    更新日期:2011-01-01 00:00:00

  • Targeted Inhibition of Leucine-Rich Repeat and Immunoglobulin Domain-Containing Protein 1 in Transplanted Neural Stem Cells Promotes Neuronal Differentiation and Functional Recovery in Rats Subjected to Spinal Cord Injury.

    abstract:OBJECTIVE:Leucine-rich repeat and immunoglobulin domain-containing protein (LINGO)-1 is expressed in neural stem cells, and its neutralization results in sustained neuronal immaturity. Thus, targeted inhibition of LINGO-1 via RNA interference may enhance transplanted neural stem cell survival and neuronal differentiati...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000001351

    authors: Chen N,Cen JS,Wang J,Qin G,Long L,Wang L,Wei F,Xiang Q,Deng DY,Wan Y

    更新日期:2016-03-01 00:00:00

  • Effect of increased radiant warmer power output on state of hydration in the critically ill neonate.

    abstract::To correlate radiant warmer bed power output with state of hydration in the critically ill infant, warmer power input was measured by a wattmeter and recorded by an on-line computer every 5 sec for 2 periods of 8-24 h each in 11 newborns with respiratory distress syndrome (mean birth weight 1.42 kg, mean gestational a...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198210000-00012

    authors: Engle WD,Baumgart S,Fox WW,Polin RA

    更新日期:1982-10-01 00:00:00