Thromb Haemost 2007; 97(04): 608-616
DOI: 10.1160/TH06-10-0563
Platelets and Blood Cells
Schattauer GmbH

Critical temperature ranges of hypothermia-induced platelet activation: Possible implications for cooling patients in cardiac surgery

Andreas Straub
1   Department of Thoracic, Cardiac and Vascular Surgery, University of Tübingen, Germany
3   Baker Heart Research Institute, Melbourne, Australia
,
Melanie Breuer
1   Department of Thoracic, Cardiac and Vascular Surgery, University of Tübingen, Germany
,
Hans P. Wendel
1   Department of Thoracic, Cardiac and Vascular Surgery, University of Tübingen, Germany
,
Karlheinz Peter
3   Baker Heart Research Institute, Melbourne, Australia
,
Klaus Dietz
2   Department of Medical Biometry, University of Tübingen, Germany
,
Gerhard Ziemer
1   Department of Thoracic, Cardiac and Vascular Surgery, University of Tübingen, Germany
› Institutsangaben
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Publikationsverlauf

Received 04. Oktober 2006

Accepted after resubmission 30. Januar 2007

Publikationsdatum:
24. November 2017 (online)

Summary

Cooling of the patient is routinely applied in cardiac surgery to protect organs against ischemia. Hypothermia induces activation of platelets, but the effects of temperatures such as used during cardiac surgery are not well described. To investigate this in an in-vitro study heparinized whole blood was incubated at different temperatures (37°C, 34.5°C, 32°C, 29.5°C, 27°C, 24.5°C, 22°C, 19.5°C and 17°C).The effect of these temperatures on aggregation, P-selectin expression, GP IIb/IIIa activation and platelet microparticle (PMP) formation of unstimulated and ADP-stimulated platelets of 36 subjects was evaluated in flow cytometry. A four-parametric logistic model was fitted to depict the temperature effect on platelet parameters. Lower temperatures increased aggregates, P-selectin expression, and GP IIb/IIIa activation. The number of PMPs decreases with hypothermia. Additional experiments revealed a slight influence of heparin on platelet P-selectin expression but excluded an effect of this anticoagulant on the other evaluated parameters. Threshold temperatures, which mark 5% changes of platelet parameters compared to values at 37°C, were calculated. On ADP-stimulated platelets the thresholds for P-selectin expression and GP IIb/IIIa activation are 34.0°C and 36.4°C, respectively, and lie in the temperature range routinely applied in cardiac surgery. Hypothermia- induced platelet activation may develop in most patients undergoing cardiac surgery, possibly resulting in thromboembolic events, coagulation defects, and proinflammatory leukocyte bridging by P-selectin bearing platelets and PMPs. These findings suggest that pharmacological protection of platelets against hypothermia-induced damage may be beneficial during cardiac surgery.

 
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