Effect Of Hypothermia Following Volume Treatment On Coagulation And Fibrinolysis

Objective Based on haemorrhagic shock model of rabbits,observing temperature changing of haemorrhagic shock of rabbits after volume treatment,studying effect of the temperature change on coagulation and fibrinolysis,to find how to redress the change of coagulation after hypothermia.Methods Twenty rabbits were divided randomly into four groups:contrast group(n=6), room temperatur group(n=6),normal temperature group(n=6) and mild hypothermia group(n=6).contrast group was bled after anesthesia without any other treat measure.room termperature was performed volume treatment with invasive arterial and venous pressure Monitoring after bled for a hour,without any special warming measure at room temperature condition.normal termperature group was transfused 60oC fluid warmed with warmer, meanwhile we warmed rabbits body surface with hot water sack of 40oC,to make rabbits body temperature recover to normal level(38.0±0.2oC) during treatment.mild hypothermia group was transfused 40oC fluid warmed with warmer, meanwhile we warmed rabbits body surface with hot water sack of 40oC,to make rabbits body temperature recover to mild hypothermia level(35.5±0.5oC) during treatment.Every group was drawn blood sample to be detected before being bled,bled for a hourand two hours.HCT,PLT,PT,PTT,TT,Fib,AT-Ⅲ and D-dimer was detect.we selected heart surgery patient under exreacorporeal circulation,drew blood sample before surgery,rewarming and after rewarmng,to detect Fib, D-dimer and TEG.Results (1) Duplicating volume treatment model after haemorrhagic shock bleeding based on MAP,which had high stability,was easy to be replicated in rabbits,the model could fulfill need of experiment.(2) Volume treatment worsened temperature decreasing of haemorrhagic shock rabbits,there was significant difference comparing with contrast group(P<0.05).(3) Comparing degree of hemodilution of room termperature group with normal termperatrue group and mild hypothermia group,there was no difference,but which of normal termperature group was notablely lower than mild hypothermia group(P<0.01).(4) Body termperature decreasing of rabbits after volume treatment suppressed coagulation,Time of Pt(P<0.01) and PTT(P<0.05) in room temperature group increased,Fib decreased(P<0.01) compared with contrast group after bled for two hours.Content of Fib decreased significantly in operation on heart under exreacorporeal circulation condition compared with rewarming(P<0.01),D-dimer increased a little,but there wasn't difference between two groups.R-time lengthened significantly (P<0.01);K-time increased obviously(P<0.01);Result of Angle shortened obviously compared with rewarming(P<0.05). (5) Coagulation of normal temperature group changed little,there was no difference compared with contrast group.(6) There was no effect of mild hypothermia group on coagulation,no difference compared with normal termperature group.Conclusion (1) Intubating into carotid artery and carotid vein,controlling bleeding volume based on MAP,we could duplicate suitable haemorrhagic shock model of rabbits.(2) Volume treatment could worsen body temperature decreasing of haemorrhagic shock rabbits at room temperature condition.(3) Body temperature decreasing following volume treatment of haemorrhagic shock rabbits suppressed coagulation,but there was no effect on fibrinolysis.This kind of suppression could be reversed when we rewarmed rabbits temperature t (38.0±0.2oC),which could recover to normal level after volume treatment finished.(4) There was no effect on coagulation when we kept haemorrhagic shock rabbits in mild hypothermia,which was a safe resuscitation measure when performing volume treatment...