KMID : 0356920200730040334
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Korean Journal of Anesthesiology 2020 Volume.73 No. 4 p.334 ~ p.341
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Influence of alcohol consumption on blood coagulation in rotational thromboelastometry (ROTEM): an in-vivo study
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Eismann Hendrik
Sieg Lion Ahmed Hala Teske Joerg Behrendt Patrick Friedrich Lars Schumacher Carsten Johanning Kai
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Abstract
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Background: Twenty-five to 85% of trauma patients are under the influence of alcohol in addition to experiencing injury-related coagulation impairment. Viscoelastic point-of-care tests (thrombelastography [TEG], rotational thromboelastometry [ROTEM]) are popular tools for rapid hemostasis assessment and therapeutic decision-making in this and other settings. While alcohol affects these tests in-vitro, their specific effects in-vivo are unclear. Therefore, we evaluated the effects of alcohol ingestion on ROTEM parameters.
Methods: Twenty volunteers provided informed consent to drinking red wine, whisk(e)y, or vodka to a target blood alcohol concentration of 1¢¶ within one hour, calculated with the Widmark formula. Blood samples were collected before drinking, at a breath alcohol concentration of 0.5¢¶, and at 1.0¢¶, but no later than one hour. After each blood collection, ExTEM and FibTEM tests were performed directly "at the bedside."
Results: All participants had a blood alcohol concentration (BAC) of 0.00¢¶ at the beginning. The mean BACs at the second and third collection were 0.48 and 0.76¢¶, respectively. There were no significant differences in the ExTEM parameters. FibTEM measurements showed a significant difference at the A10 value (13.0 vs. 14.0 mm, P = 0.014) and a trend at the maximum amplitude (maximum clot firmness 13.7 vs. 16.2 mm, P = 0.075). We saw no significant differences in fibrinolysis parameters and no hyperfibrinolysis in our ROTEM measurements.
Conclusions: Ethanol ingestion can impair early fibrin polymerization. These results might be of special relevance in trauma and support routine application of ROTEM/TEG in such cases.
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KEYWORD
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Alcoholic intoxication, Blood coagulation test, Ethanol, Point-of-care testing
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