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Effect of hypothermia on haemostasis and bleeding risk : a narrative review

KANDER, THOMAS LU orcid and Schott, Ulf LU (2019) In Journal of International Medical Research 47(8). p.3559-3568
Abstract

It must be remembered that clinically important haemostasis occurs in vivo and not in a tube, and that variables such as the number of bleeding events and bleeding volume are more robust measures of bleeding risk than the results of analyses. In this narrative review, we highlight trauma, surgery, and mild induced hypothermia as three clinically important situations in which the effects of hypothermia on haemostasis are important. In observational studies of trauma, hypothermia (body temperature <35°C) has demonstrated an association with mortality and morbidity, perhaps owing to its effect on haemostatic functions. Randomised trials have shown that hypothermia causes increased bleeding during surgery. Although causality between... (More)

It must be remembered that clinically important haemostasis occurs in vivo and not in a tube, and that variables such as the number of bleeding events and bleeding volume are more robust measures of bleeding risk than the results of analyses. In this narrative review, we highlight trauma, surgery, and mild induced hypothermia as three clinically important situations in which the effects of hypothermia on haemostasis are important. In observational studies of trauma, hypothermia (body temperature <35°C) has demonstrated an association with mortality and morbidity, perhaps owing to its effect on haemostatic functions. Randomised trials have shown that hypothermia causes increased bleeding during surgery. Although causality between hypothermia and bleeding risk has not been well established, there is a clear association between hypothermia and negative outcomes in connection with trauma, surgery, and accidental hypothermia; thus, it is crucial to rewarm patients in these clinical situations without delay. Mild induced hypothermia to ≥33°C for 24 hours does not seem to be associated with either decreased total haemostasis or increased bleeding risk.

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author
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organization
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type
Contribution to journal
publication status
published
subject
keywords
bleeding, coagulopathy, haemostasis, Hypothermia, injury, surgery, trauma
in
Journal of International Medical Research
volume
47
issue
8
pages
3559 - 3568
publisher
SAGE Publications
external identifiers
  • scopus:85071747979
  • pmid:31475619
ISSN
0300-0605
DOI
10.1177/0300060519861469
language
English
LU publication?
yes
id
2dde0149-437d-475b-85ab-5e3a43f5ff1c
date added to LUP
2019-09-02 17:28:53
date last changed
2024-04-16 19:12:41
@article{2dde0149-437d-475b-85ab-5e3a43f5ff1c,
  abstract     = {{<p>It must be remembered that clinically important haemostasis occurs in vivo and not in a tube, and that variables such as the number of bleeding events and bleeding volume are more robust measures of bleeding risk than the results of analyses. In this narrative review, we highlight trauma, surgery, and mild induced hypothermia as three clinically important situations in which the effects of hypothermia on haemostasis are important. In observational studies of trauma, hypothermia (body temperature &lt;35°C) has demonstrated an association with mortality and morbidity, perhaps owing to its effect on haemostatic functions. Randomised trials have shown that hypothermia causes increased bleeding during surgery. Although causality between hypothermia and bleeding risk has not been well established, there is a clear association between hypothermia and negative outcomes in connection with trauma, surgery, and accidental hypothermia; thus, it is crucial to rewarm patients in these clinical situations without delay. Mild induced hypothermia to ≥33°C for 24 hours does not seem to be associated with either decreased total haemostasis or increased bleeding risk.</p>}},
  author       = {{KANDER, THOMAS and Schott, Ulf}},
  issn         = {{0300-0605}},
  keywords     = {{bleeding; coagulopathy; haemostasis; Hypothermia; injury; surgery; trauma}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{3559--3568}},
  publisher    = {{SAGE Publications}},
  series       = {{Journal of International Medical Research}},
  title        = {{Effect of hypothermia on haemostasis and bleeding risk : a narrative review}},
  url          = {{http://dx.doi.org/10.1177/0300060519861469}},
  doi          = {{10.1177/0300060519861469}},
  volume       = {{47}},
  year         = {{2019}},
}