Effects of Hyperbaric and Decompression Stress on Blood Coagulation and Fibrinolysis

Peng, Henry T.; Cameron, Bruce A.; Rhind, Shawn G.

doi:10.1177/1076029614568712

Cited by 4 publications

(6 citation statements)

References 35 publications

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“…It has also been demonstrated that decompression stress led to an earlier onset of clot formation at 75 min through to 5 h post-dive. This hypercoagulable state was continuous until 5 h after the dive and was shown to resolve at 24-h post-dive [24]. The current findings agree somewhat with this study in that we also observed a shift towards a more pro-thrombotic state although the methodologies in terms of protocol and analysis are very different.…”

Section: Discussionsupporting

confidence: 90%

Coagulation Profiles in Humans Exposed to Exertional Hypobaric Decompression Stress Determined by Calibrated Automated Thrombogram

Madden,

Vince,

Edwards

et al. 2023

Hemato

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The blood coagulation response to decompression stress in humans has yet to be fully investigated. Here we utilised calibrated automated thrombogram (CAT) on samples from healthy volunteers exposed to decompression stress to investigate real-time thrombin generation. To induce decompression stress, fifteen apparently healthy males (age 20–50 yr) were exposed to two consecutive ascents to 25,000 ft for 60 min (1st ascent) and then 90 min (2nd ascent) while breathing 100% oxygen. Citrated blood samples were taken prior to exposure (T0), following the 2nd ascent (T8) and at 24 h (T24). Thrombin generation curves were obtained using ThrombinoscopeTM. Parameters determined were lag time (LAG), time to peak (TTP), peak thrombin (PEAK), endogenous thrombin potential (ETP) and velocity index (VEL). Of the 15 subjects, 12 had validated coagulation profiles. TTP and ETP showed no significant differences. However, there was a significant increase in VEL from T0 to T8 (p = 0.025) and from T8 to T24 (p = 0.043). A non-significant trend of an overall increase in PEAK was also observed from T0 to T8 (p = 0.069) and from T8 to T24 (p = 0.098). PEAK and VEL were found to be correlated. Taken together, these two parameters suggest an overall shift towards a more procoagulant profile following hypobaric stress.

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Section: Discussionsupporting

confidence: 90%

Coagulation Profiles in Humans Exposed to Exertional Hypobaric Decompression Stress Determined by Calibrated Automated Thrombogram

Madden,

Vince,

Edwards

et al. 2023

Hemato

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“…The strongest correlations between TEG MA and ROTEM MCF among all measured parameters are consistent with other studies comparing TEG and ROTEM tests using no activators 16 or activators (e.g., kaolin-activated TEG vs. extem and in-tem activated ROTEM). 15,18,41 Furthermore, our study showed a similar correlation coefficient between the standard TEG FF MA and ROTEM FIBTEM MCF to another study comparing the two functional fibrinogen assays (0.75 vs. 0.71). 24 In addition, we found significant correlations among other corresponding parameters (e.g., between K and CFT, and between TEG Alpha and ROTEM Alpha) although they were not well reported and compared in TEG and ROTEM fibrinogen assays.…”

Section: Discussionsupporting

confidence: 82%

“…Generally, higher correlations were seen when the same ROTEM FIBTEM reagents (extem and fibtem) were used on both TEG and ROTEM, which is consistent with our previous comparative study on other TEG and ROTEM assays. 41 Next, we used the Bland-Altman difference mean plots to determine the agreement between the TEG and ROTEM parameters. Table 3 shows the limits of agreement (LoA) calculated from the results as described in Methods.…”

Section: Resultsmentioning

confidence: 99%

A Comparative Analysis of Functional Fibrinogen Assays using TEG and ROTEM in Trauma Patients Enrolled in the FiiRST Trial

Tien¹,

Peng²,

Nascimento³

et al. 2018

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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Introduction:Given the growing use of both thrombelastography (TEG) and rotational thromboelastometry (ROTEM) in trauma and surgery, it is important to determine whether the two are interchangeable, and how comparable they are to Clauss fibrinogen assay and for clinical use. We recently completed a randomized control trial on early fibrinogen in trauma (the FiiRST trial). The object of this analysis was to evaluate the interchangeability and correlations between TEG and ROTEM functional fibrinogen assays in injured trauma patients. Also, we evaluated their correlation with Clauss fibrinogen and compared their potentials for diagnosis of coagulopathy and use in guided fibrinogen administration. Materials and Methods:The Post-hoc analysis of the coagulation data collected as part of the FiiRST trial. It was a comparative analysis of functional fibrinogen assays using TEG and ROTEM in trauma patients screened for hypotension and need for blood transfusion. TEG and ROTEM tests were also compared with Clauss fibrinogen assay and INR as additional analyses of their clinical use.Results: TEG and ROTEM parameter values were correlated but were significantly different, and their agreement fell outside acceptable limits and thus were not interchangeable. TEG maximum amplitude (MA) and ROTEM maximum clot firmness (MCF) showed closest correlations with Clauss fibrinogen concentration, particularly with ROTEM FIBTEM MCF (r = 0.84; p < 0.001). There were discrepancies between TEG and ROTEM in their detection of coagulation abnormalities, hypofibrinogenemia, and hyperfibrinolysis.Conclusion: TEG and ROTEM fibrinogen assay parameters were associated, especially between TEG MA and ROTEM MCF, showing the strongest correlation, but the parameters were not interchangeable. TEG and ROTEM showed varying extents of correlations with Clauss fibrinogen. Overall, ROTEM parameters exhibited better correlations with Clauss fibrinogen than TEG. Different algorithms for TEG and ROTEM need to be developed for diagnosis of coagulopathy and guided fibrinogen administration in trauma.

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“…Peng et al [ 20 ] observed a reduction in the time required for clot formation in trained naval divers 75 min and 5 h after they were subjected to decompressive stress in a hyperbaric chamber. These results corroborate those of a study by Monaca et al [ 18 ], who observed induction of the procoagulatory axis in humans with underlying disease who underwent a session of HBOT at 2.4 ATAs for 90 min.…”

Section: Discussionmentioning

confidence: 99%

“…Thromboelastography and thromboelastometry are used as global measures of blood coagulation and fibrinolysis in various research and clinical settings, allowing observation of diving-induced hemostatic changes in humans [ 20 ]. Nevertheless, hemostasis is a complex process involving dynamic interactions between vessels, platelets and coagulation proteins, with buccal mucosal bleeding time (BMBT) being probably the best measurement of platelet plug formation and function platelet in vivo [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Hyperbaric Oxygen Therapy on Hemogram, Serum Biochemistry and Coagulation Parameters of Dogs Undergoing Elective Laparoscopic-Assisted Ovariohysterectomy

Antunes,

Caye,

Schiefler

et al. 2024

Animals

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Background: This study explored the effects of hyperbaric oxygen therapy (HBOT) on hemogram, serum biochemistry and hemostatic variables in female dogs undergoing laparoscopic-assisted ovariohysterectomy (OVH). Materials: Thirty adult, mixed-breed, healthy female dogs were randomly divided into the following three groups: HBOT + SURG (exposed to two absolute atmospheres (ATAs) for 45 min followed by laparoscopic-assisted OVH), HBOT (exposed to two ATAs for 45 min) and SURG (laparoscopic-assisted OVH). Blood samples were collected at T0 (at the admission), at T1, 24 h after T0 (immediately after HBOT in the HBOT + SURG and HBOT groups, and immediately before anesthetic premedication in the SURG group), and at T2, 48 h after T0 (24 h after HBOT and anesthetic premedication). Methods: Assessments included erythrogram, leukogram, thrombogram, renal and hepatic serum biochemistry, prothrombin time (PT), activated partial thromboplastin time (APTT), buccal mucosal bleeding time (BMBT) and bloodstain area (BA) on hygroscopic paper collected at the BMBT. Results: Both the HBOT + SURG and SURG groups presented neutrophilia (p ≤ 0.0039) at T2 and an increase of ALP at T2 (p ≤ 0.0493), the SURG group presented an increase in leukocyte count at T2 (p = 0.0238) and the HBOT + SURG group presented a reduction in lymphocyte count at T2 (p = 0.0115). In the HBOT + SURG group, there was a reduction in PT and APTT in relation to the baseline value (p ≤ 0.0412). Conclusions: A session of HBOT at two ATAs for 45 min did not cause changes in the BMBT or BA in healthy female dogs. Some blood parameters investigated (neutrophil and lymphocyte count, ALP, PT and APTT) were affected by the use of HBOT.

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Effects of Hyperbaric and Decompression Stress on Blood Coagulation and Fibrinolysis

Cited by 4 publications

References 35 publications

Coagulation Profiles in Humans Exposed to Exertional Hypobaric Decompression Stress Determined by Calibrated Automated Thrombogram

Coagulation Profiles in Humans Exposed to Exertional Hypobaric Decompression Stress Determined by Calibrated Automated Thrombogram

A Comparative Analysis of Functional Fibrinogen Assays using TEG and ROTEM in Trauma Patients Enrolled in the FiiRST Trial

Effects of Hyperbaric Oxygen Therapy on Hemogram, Serum Biochemistry and Coagulation Parameters of Dogs Undergoing Elective Laparoscopic-Assisted Ovariohysterectomy

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