Department of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany.
Anaesthesia. 2010 Jul;65(7):688-91. doi: 10.1111/j.1365-2044.2010.06367.x. Epub 2010 May 11.
Hypothermia and acidosis lead to an impairment of coagulation. It has been demonstrated that desmopressin improves platelet function under hypothermia. We tested platelet function ex vivo during hypothermia and acidosis. Blood samples were taken from 12 healthy subjects and assigned as follows: normal pH, pH 7.2, and pH 7.0, each with and without incubation with desmopressin. Platelet aggregation was assessed by multiple electrode aggregometry. Baseline was normal pH and 36 degrees C. The other samples were incubated for 30 min and measured at 32 degrees C. Acidosis significantly impaired aggregation. Desmopressin significantly increased aggregability during hypothermia and acidosis regardless of pH, but did not return it to normal values at low pH. During acidosis and hypothermia, acidosis should be corrected first; desmopressin can then be administered to improve platelet function as a bridge until normothermia can be achieved.
低体温和酸中毒会导致凝血功能受损。已经证明，去氨加压素可改善低体温下的血小板功能。我们在低体温和酸中毒的情况下进行了体外血小板功能检测。从 12 名健康受试者中采集血液样本，并进行如下分组：正常 pH 值、pH 值 7.2 和 pH 值 7.0，每组均有无去氨加压素孵育。通过多电极聚集仪评估血小板聚集。基础状态为正常 pH 值和 36 摄氏度。其他样本孵育 30 分钟，并在 32 摄氏度下测量。酸中毒显著降低了聚集能力。去氨加压素在低体温和酸中毒时显著增加了聚集性，无论 pH 值如何，但在低 pH 值时并未使其恢复正常水平。在酸中毒和低体温期间，应首先纠正酸中毒；然后可以给予去氨加压素来改善血小板功能，作为恢复正常体温的桥梁。
