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Reduced coagulation at high altitude identified by thromboeslastography

Reduced coagulation at high altitude identified by thromboeslastography
Reduced coagulation at high altitude identified by thromboeslastography
The impact of hypoxaemia on blood coagulation remains unclear despite use of a variety of measures to address the issue. We report the first use of thromboelastography (TEG) at high altitude to describe the dynamics of clot formation in whole blood samples. Seventeen healthy volunteers ascended to 5,300 m following an identical ascent profile; TEG measurements at 4,250 m and 5,300 m were compared with those from sea level. Peripheral oxygen saturation (SpO2) and haematocrit were also measured. Ascent resulted in a decline in SpO2 from 97.8 (± 1.2) % at sea level to 86.9 (± 3.3) % at 4,250 m and 79.5 (± 5.8) % at 5,300 m (p<0.001); haematocrit rose from 43.7 (± 2.8) % at sea level, to 46.7 (± 3.9) % and 52.6 (± 3.2) % at 4,250 m and 5,300 m, respectively (p<0.01). TEG reaction (R)-time and kinetic (K)-time were both increased at 5,300 m compared to sea level, 8.95 (± 1.37) minutes (min) to 11.69 (± 2.91) min (p=0.016) and 2.40 (± 0.66) min to 4.99 (± 1.67) min (p<0.001), respectively. Additionally the alpha (?)- angle was decreased from 57.7 (± 8.2) to 51.6 (± 6.4) (p<0.001). There was no change in maximum amplitude (MA) on ascent to altitude. These changes are consistent with an overall pattern of slowed coagulation at high altitude.
hypoxia, blood coagulation, blood, thrombelastography, coagulation tests, altitude
0340-6245
1066-1071
Martin, Daniel S.
3e441b48-9221-4308-8ae6-49cbde20753f
Pate, Jim S.
fc4cad12-78f6-426b-a8d7-ec6fbbe4d000
Vercueil, Andre
2c8603fa-d72f-47ab-9cda-3a15f8e49867
Doyle, Patrick W.
56be81d6-018e-49d5-bc5f-50d7313f7f57
Mythen, Michael G.
940f5be7-e5bc-4a90-94aa-09fdc658caad
Grocott, Mike P.W.
1e87b741-513e-4a22-be13-0f7bb344e8c2
Caudwell Xtreme Everest Research Group
Martin, Daniel S.
3e441b48-9221-4308-8ae6-49cbde20753f
Pate, Jim S.
fc4cad12-78f6-426b-a8d7-ec6fbbe4d000
Vercueil, Andre
2c8603fa-d72f-47ab-9cda-3a15f8e49867
Doyle, Patrick W.
56be81d6-018e-49d5-bc5f-50d7313f7f57
Mythen, Michael G.
940f5be7-e5bc-4a90-94aa-09fdc658caad
Grocott, Mike P.W.
1e87b741-513e-4a22-be13-0f7bb344e8c2

Martin, Daniel S., Pate, Jim S., Vercueil, Andre, Doyle, Patrick W., Mythen, Michael G. and Grocott, Mike P.W. , Caudwell Xtreme Everest Research Group (2012) Reduced coagulation at high altitude identified by thromboeslastography. Thrombosis and Haemostasis, 107 (6), 1066-1071. (doi:10.1160/TH12-01-0004). (PMID:22437051)

Record type: Article

Abstract

The impact of hypoxaemia on blood coagulation remains unclear despite use of a variety of measures to address the issue. We report the first use of thromboelastography (TEG) at high altitude to describe the dynamics of clot formation in whole blood samples. Seventeen healthy volunteers ascended to 5,300 m following an identical ascent profile; TEG measurements at 4,250 m and 5,300 m were compared with those from sea level. Peripheral oxygen saturation (SpO2) and haematocrit were also measured. Ascent resulted in a decline in SpO2 from 97.8 (± 1.2) % at sea level to 86.9 (± 3.3) % at 4,250 m and 79.5 (± 5.8) % at 5,300 m (p<0.001); haematocrit rose from 43.7 (± 2.8) % at sea level, to 46.7 (± 3.9) % and 52.6 (± 3.2) % at 4,250 m and 5,300 m, respectively (p<0.01). TEG reaction (R)-time and kinetic (K)-time were both increased at 5,300 m compared to sea level, 8.95 (± 1.37) minutes (min) to 11.69 (± 2.91) min (p=0.016) and 2.40 (± 0.66) min to 4.99 (± 1.67) min (p<0.001), respectively. Additionally the alpha (?)- angle was decreased from 57.7 (± 8.2) to 51.6 (± 6.4) (p<0.001). There was no change in maximum amplitude (MA) on ascent to altitude. These changes are consistent with an overall pattern of slowed coagulation at high altitude.

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Published date: June 2012
Keywords: hypoxia, blood coagulation, blood, thrombelastography, coagulation tests, altitude
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 341308
URI: http://eprints.soton.ac.uk/id/eprint/341308
ISSN: 0340-6245
PURE UUID: 47a60326-3c33-46d5-840b-8997a3b738cb
ORCID for Mike P.W. Grocott: ORCID iD orcid.org/0000-0002-9484-7581

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Date deposited: 19 Jul 2012 08:40
Last modified: 15 Mar 2024 03:33

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Contributors

Author: Daniel S. Martin
Author: Jim S. Pate
Author: Andre Vercueil
Author: Patrick W. Doyle
Author: Michael G. Mythen
Corporate Author: Caudwell Xtreme Everest Research Group

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