Assessment of hemostaseologic alterations induced by hyperbaric oxygen therapy using point-of-care analyzers

摘要

Background: Exposure to hyperbaric conditions influences the coagulation system. Thromboembolic events and disseminated intravascular coagulation were observed. Objectives: To detect the effects of a hyperbaric environment on the human coagulation system using the point-of-care coagulation analyzers Multiplate ? and ROTEM?. Patients/Methods: 20 patients were included. Each received 90 minutes of oxygen intermittently at 2.4 atmospheres absolute, as per the TS 240-90 wound-healing protocol. Blood samples were taken before and after hyperbaric exposure and ROTEM?, Multiplate? and standard laboratory assays were subsequently performed. Results: ROTEM? showed a significant increase of the maximum clot firmness (EXTEM MCF; p0.05) and the thromboelastometric platelet component of the clot firmness (MCFEXTEM - MCFFIBTEM; p0.01). Multiplate? showed a platelet activation mediated by thrombin (AU TRAP-test; p0.05) and by arachidonic acid (AUC ASPI-test; p0.01). Standard laboratory assays revealed a lower activated partial thromboplastin time (p0.05) and a higher leukocyte count (p0.05). No further changes were detected. A t-test was performed after testing if data followed normal distribution. Conclusions: ROTEM? and Multiplate? were able to detect an activation of platelets after HBO2 therapy via thrombin and arachidonic acid pathways. Previously reported fibrinolysis could not be confirmed.