Effects of Ethanol Intoxication and Gender on Blood Coagulation

Spoerke, Nicholas J.; Underwood, Samantha J.; Differding, Jerome A.; van, P.F.M.M. Bergen; Sambasivan, Chitra N.; Shapiro, David S.; Schreiber, Merritt

doi:10.1097/ta.0b013e3181d86860

Cited by 23 publications

(33 citation statements)

References 19 publications

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“…While the incidence of DVT in the ETOHÀ group is high, this is potentially related to our institutional practice of obtaining weekly whole leg duplex examinations and has been validated in other studies from our institution [20,21]. The observation that alcohol is associated with an acquired hypocoagulable state is consistent with our previous work with normal volunteers suggesting that R-time, alpha angle and maximum amplitude are all decreased after acute ethanol ingestion [7] (Fig. 2).…”

Section: Discussionsupporting

confidence: 86%

“…While chronic alcohol consumption has been associated with a clinically significant decrease in DVT incidence, the relative coagulopathy associated with acute alcohol intake has yet to be proven to be clinically significant [5][6][7][8]. This study is the first to demonstrate a clinically significant association between acute alcohol intake and DVT incidence in trauma patients.…”

Section: Discussionmentioning

confidence: 95%

“…This hypocoagulable state observed with chronic use may also occur in the acute phase as we have previously shown that healthy volunteers develop a hypocoagulable state, as measured by thrombelastogram (TEG), following alcohol ingestion [7]. The mechanism underlying this hypocoagulability remains incompletely elucidated though decreased fibrinogen and platelet counts, decreased fibrin cross-linking and altered expression of factor VII, tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) potentially contribute [7,8].…”

Section: Introductionmentioning

confidence: 91%

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Positive blood alcohol is associated with reduced DVT in trauma

Cook

Louis

McCully

et al. 2015

Injury

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 91%

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Positive blood alcohol is associated with reduced DVT in trauma

Cook

Louis

McCully

et al. 2015

Injury

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“…Posterior bleeding usually led to more invasive treatments than anteriorly located ones and therefore poses a greater burden on the patient. Alcohol is already known to interfere with coagulation, thrombocyte function and fibrinolysis [24,25]. Despite the fact that coagulopathies, thrombocyte dysfunction and alcohol lead to epistaxis, they were shown to be associated with posterior and severe bleedings [1,14].…”

Section: Discussionmentioning

confidence: 99%

Blood markers of alcohol use in epistaxis patients

Soyka

Schrepfer

Holzmann

2011

Eur Arch Otorhinolaryngol

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Epistaxis and alcohol overconsumption are frequently encountered in patients admitted to emergency wards. The aim of the study was to analyze indirect markers of alcohol overconsumption in epistaxis patients and evaluate its role as a risk factor. In a cohort of 510 epistaxis patients indirect markers of alcohol overuse were measured including the mean corpuscular volume (MCV), gamma glutamyltransferase (GGT), aspartate aminotransferase and alanine aminotransferase. The results were compared to the normal findings in literature. Pathologic mean levels of GGT were found in epistaxis patients. Almost 5% had macrocytosis and MCV correlated positively with liver enzyme levels. Platelet counts were negatively correlated with both corpuscular volumes and liver enzymes. Indirect markers of alcohol overconsumption were found to be elevated in epistaxis patients. These results suggest that a subgroup of epistaxis patients overconsumes alcoholic beverages supporting the idea of alcohol abuse being a risk factor in epistaxis. Questioning about drinking habits should be employed and help offered to affected patients.

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“…Weiterhin wurden mit der Einnahme von Alkohol vergesellschaftete hypokoagulabile Zustände mit reduzierter Fibrinbildung, Fibrinquervernetzung und daraus resultierend verminderter Gerinnselfestigkeit beschrieben [86]. Dieser Effekt ist möglicherweise geschlechterspezifisch mit positiver Korrelation zum Alkoholkonsum beim männlichen Geschlecht.…”

Section: Empfehlung Der Konsensusgruppeunclassified

Frühe viskoelastizitätsbasierte Gerinnungstherapie bei blutenden Schwerverletzten

et al. 2015

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Although there is increasing interest in the use of a viscoelastic test procedure (ROTEM/TEG) for diagnostics and therapy guidance of severely injured and bleeding patients, currently no uniformly accepted guidelines exist for how this technology should be integrated into clinical treatment. In September 2014 an international multidisciplinary group of opinion leaders in the field of trauma-induced coagulopathy and other disciplines involved in the treatment of severely injured patients were assembled for a 2-day consensus conference in Philadelphia (USA). This panel included trauma/accident surgeons, general/abdominal surgeons, vascular surgeons, emergency/intensive care surgeons, hematologists, transfusion specialists, anesthesiologists, laboratory physicians, pathobiologists/pathophysiologists and the lay public. A total of nine questions regarding the impact of viscoelastic testing in the early treatment of trauma patients were developed prior to the conference by a panel consensus. Early use was defined as baseline viscoelastic test result thresholds obtained within the first minutes of hospital arrival, when conventional laboratory results are not yet available. The available data for each question were then reviewed in person using standardized presentations by the expert panel. A consensus summary document was then developed and reviewed by the panel in an open forum. Finally, a 2-round Delphi poll was administered to the panel of experts regarding viscoelastic thresholds for triggering the initiation of specific treatments including fibrinogen (concentrates), platelet concentrates, blood plasma products and prothrombin complex concentrates (PCC). This report summarizes the findings and recommendations of this consensus conference, which correspond to a S2k guideline according to the system of the Association of the Scientific Medical Societies in Germany (AWMF) and taking formal consensus findings including Delphi methods into consideration.

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Effects of Ethanol Intoxication and Gender on Blood Coagulation

Abstract: Consumption of commonly ingested quantities of alcohol correlated with the development of a hypocoagulable state in men but had no effect on coagulation status in women. This phenomenon may contribute to differences in post-trauma coagulation status previously noted between genders.

Cited by 23 publications

References 19 publications

Positive blood alcohol is associated with reduced DVT in trauma

Positive blood alcohol is associated with reduced DVT in trauma

Blood markers of alcohol use in epistaxis patients

Frühe viskoelastizitätsbasierte Gerinnungstherapie bei blutenden Schwerverletzten

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