Hemostatic responses to exercise, dehydration, and simulated bleeding in heat-stressed humans
Borgman MA, Zaar M, Aden JK, Schlader ZJ, Gagnon D, Rivas E, Kern J, Koons NJ, Convertino VA, Cap AP, Crandall C
American journal of physiology. Regulatory, integrative and comparative physiology · 22 citations
How it was studied
- Design
- Controlled clinical trial (classified by our AI screen)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
- Government
- U.S. Department of Defense
- Government
- National Institutes of Health
- Government
- National Heart, Lung, and Blood Institute
- Government
- U.S. Department of Defense (DOD)
- Government
- NHLBI NIH HHS
- Grants
- U.S. Department of Defense (W81XWH1210152); National Heart, Lung, and Blood Institute (R01HL061388); National Institutes of Health (HL‐61388)
Based on 5 listed funder(s).
Publication
- Published
- 2018-09-19 · Am J Physiol Regul Integr Comp Physiol · vol. 316 · issue 2 · pp. R145–R156
- Publisher
- American Physiological Society
- Cited
- 32 citations · more than 79% of similar papers · 1.3× the field average
- References
- 45 works
- Access
- Open access (repository copy)
- Research areas
- Thermoregulation and physiological responses · Climate Change and Health Impacts · Trauma, Hemostasis, Coagulopathy, Resuscitation
- Keywords
- Presyncope, Fibrinolysis, Medicine, Hyperthermia, Hemostasis, Hypovolemia, Internal medicine, Thromboelastography, Anesthesia, Blood pressure, Platelet, Heart rate
- MeSH
- humans, dehydration, heat stress disorders, hemorrhage, hypovolemia, lower body negative pressure, exercise, hyperthermia, induced, heat-shock response, hemostasis, adult, male, hot temperature, arterial pressure
11 authors
From US, CA
- Matthew A. Borgman · correspondingBrooke Army Medical Center; United States Army Institute of Surgical Research; Joint Base San Antonio
- Morten ZaarUnited States Army Institute of Surgical Research
- James Keith AdenBrooke Army Medical Center; Joint Base San Antonio
- Zachary J. SchladerUniversity at Buffalo, State University of New York
- Daniel GagnonMontreal Heart Institute; Université de Montréal
- Eric RivasTexas Tech University
Abstract
Heat stress followed by an accompanying hemorrhagic challenge may influence hemostasis. We tested the hypothesis that hemostatic responses would be increased by passive heat stress, as well as exercise-induced heat stress, each with accompanying central hypovolemia to simulate a hemorrhagic insult. In aim 1, subjects were exposed to passive heating or normothermic time control, each followed by progressive lower-body negative pressure (LBNP) to presyncope. In aim 2 subjects exercised in hyperthermic environmental conditions, with and without accompanying dehydration, each also followed by progressive LBNP to presyncope. At baseline, pre-LBNP, and post-LBNP (30)] to 5.1% post-LBNP compared with 1.5% (time control) and 2.7% in N-LBNP ( P = 0.05 for main effect). Hyperthermia also potentiated increased platelet counts post-LBNP as follows: 274 K/µl for H-LBNP, 246 K/µl for N-LBNP, and 196 K/µl for time control ( P 30) was increased to 6-10% when subjects were dehydrated compared with an increase to 2-4% when hydrated ( P = 0.05 for treatment). Central hypovolemia via LBNP is a primary driver of hemostasis compared with hyperthermia and dehydration effects. However, hyperthermia does induce significant thrombocytosis and by itself causes an increase in clot lysis. Dehydration associated with exercise-induced heat stress increases clot lysis but does not affect exercise-activated or subsequent hypovolemia-activated hemostasis in hyperthermic humans. Clinical implications of these findings are that quickly restoring a hemorrhaging hypovolemic trauma patient with cold noncoagulant fluids (crystalloids) can have serious deleterious effects on the body's innate ability to form essential clots, and several factors can increase clot lysis, which should therefore be closely monitored.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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