Valeri C R, Feingold H, Cassidy G, Ragno G, Khuri S, Altschule M D
Ann Surg. 1987 Feb;205(2):175-81. doi: 10.1097/00000658-198702000-00012.
Baboons that were subjected to systemic hypothermia at 32 C had an arm skin temperature of 27.3 C and bleeding time of 5.8 minutes. With local warming of the arm skin to 34 C, the bleeding time was 2.4 minutes. In normothermic baboons with arm skin temperature of 34.6 C, the bleeding time was 3.1 minutes. Local cooling of the arm skin to 27.6 C produced a bleeding time of 6.9 minutes. Increasing the skin temperature of the arm in hypothermic baboons to 38.9 C and in normothermic baboons to 40.1 C reduced bleeding times to 2.1 and 2.3 minutes, respectively. In both hypothermic and normothermic baboons there was a negative and significant correlation between the bleeding time and the arm skin temperature and the thromboxane B2 level in the shed blood obtained at the template bleeding time site. There was a significant positive correlation between the thromboxane B2 level in the shed blood and the arm skin temperature. Both in-vivo and in-vitro studies have shown that the production of thromboxane B2 by platelets is temperature-dependent, and that a cooling of skin temperature produces a reversible platelet dysfunction. Data also suggest that when a hypothermic patient bleeds without surgical cause, skin and wound temperature should be restored to normal before the administration of blood products that are not only expensive but may also transmit disease.
体温降至32℃的狒狒，其手臂皮肤温度为27.3℃，出血时间为5.8分钟。当手臂皮肤局部升温至34℃时，出血时间为2.4分钟。体温正常、手臂皮肤温度为34.6℃的狒狒，出血时间为3.1分钟。手臂皮肤局部降温至27.6℃时，出血时间为6.9分钟。将低温狒狒的手臂皮肤温度升至38.9℃，将体温正常的狒狒的手臂皮肤温度升至40.1℃，出血时间分别降至2.1分钟和2.3分钟。在低温和体温正常的狒狒中，出血时间与模板出血时间部位采集的流出血液中的手臂皮肤温度和血栓素B2水平之间均呈负相关且具有显著性。流出血液中的血栓素B2水平与手臂皮肤温度之间呈显著正相关。体内和体外研究均表明，血小板产生血栓素B2的过程与温度有关，皮肤温度降低会导致可逆性血小板功能障碍。数据还表明，当低温患者无手术原因出血时，在输注不仅昂贵而且可能传播疾病的血液制品之前，应将皮肤和伤口温度恢复正常。
