Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea.
J Anesth. 2021 Oct;35(5):633-637. doi: 10.1007/s00540-021-02969-x. Epub 2021 Jul 15.
To assess the effects of various concentrations of dexmedetomidine on the human blood coagulation profile using rotational thromboelastometry (ROTEM).
Venous blood samples were collected from 11 healthy volunteers and divided into four specimen bottles; dexmedetomidine was added to attain final sample concentrations of 0, 0.5, 1.0, and 1.5 ng/mL. ROTEM was performed on each study sample.
The concentration of dexmedetomidine increased, and the ROTEM values showed a hypercoagulable state. The change in clotting time (CT) for INTEM was larger in samples with a dexmedetomidine concentration of 1.5 ng/mL (- 34%) than in the 0.5 ng/mL samples (- 16%) (P = 0.010). The change in clot formation time (CFT) for INTEM was greater in 1.5 ng/mL samples (- 16%) than in 0.5 ng/mL samples (- 4%) (P = 0.004). A greater decrease in CT for EXTEM was identified in the 1.0 ng/mL and 1.5 ng/mL samples (- 36% and - 37%, respectively) than in the 0.5 ng/mL samples (- 12%) (P = 0.003 for both categories). The change in CFT for EXTEM was greater in the 1.0 ng/mL and 1.5 ng/mL samples (- 11% and - 13%, respectively) than in the 0.5 ng/mL samples (- 4%) (P = 0.006 and P = 0.001, respectively). A bigger change in maximum clot firmness (MCF) for EXTEM was observed in the 1.5 ng/mL samples (4%) than in the 0.5 ng/mL samples (0%) (P = 0.002). The change in MCF for FIBTEM was greater in the 1.5 ng/mL samples (19%) than in the 0.5 ng/mL samples (5%) (P = 0.001).
All coagulation pathways showed a hypercoagulable state as the concentration of dexmedetomidine increased. Nevertheless, most of the values of ROTEM were maintained within the reference ranges. Clinical Trial NCT04269278.
使用旋转血栓弹性描记术(ROTEM)评估不同浓度右美托咪定对人血液凝血谱的影响。
采集 11 名健康志愿者的静脉血样,并将其分为 4 个样本瓶;加入右美托咪定,使终末样本浓度分别达到 0、0.5、1.0 和 1.5ng/ml。对每个研究样本进行 ROTEM 检测。
随着右美托咪定浓度的增加,ROTEM 值呈现出高凝状态。INTEM 中的凝血时间(CT)变化在 1.5ng/ml 样本中(-34%)大于在 0.5ng/ml 样本中(-16%)(P=0.010)。INTEM 中凝块形成时间(CFT)的变化在 1.5ng/ml 样本中(-16%)大于在 0.5ng/ml 样本中(-4%)(P=0.004)。EXTEM 中的 CT 下降幅度在 1.0ng/ml 和 1.5ng/ml 样本中(-36%和-37%)大于在 0.5ng/ml 样本中(-12%)(两者均 P=0.003)。EXTEM 中 CFT 的变化在 1.0ng/ml 和 1.5ng/ml 样本中(-11%和-13%)大于在 0.5ng/ml 样本中(-4%)(P=0.006 和 P=0.001)。EXTEM 中最大凝块硬度(MCF)的变化在 1.5ng/ml 样本中(4%)大于在 0.5ng/ml 样本中(0%)(P=0.002)。FIBTEM 中 MCF 的变化在 1.5ng/ml 样本中(19%)大于在 0.5ng/ml 样本中(5%)(P=0.001)。
随着右美托咪定浓度的增加,所有凝血途径均呈现高凝状态。然而,大多数 ROTEM 值仍保持在参考范围内。临床试验 NCT04269278。