title: Ethanol impairs coagulation and fibrinolysis in whole blood: a study performed with rotational thromboelastometry.
abstract: The objective was to study the effects of ethanol on coagulation and fibrinolysis in whole blood. Blood samples from healthy volunteers were analyzed before and after in-vitro addition of ethanol in order to achieve ethanol concentrations of 0, 1, 2 and 4 per thousand, respectively (0, 22, 44 and 88 mmol/l). Coagulation and fibrinolysis were then assessed using rotational thromboelastometry. We found that increasing ethanol levels increasingly impaired coagulation as evaluated with rotational thromboelastometry, with a maximum prolongation of the clot formation time of 118% at an ethanol level of 4 per thousand (P < 0.000001). We also found a very strong impairment of fibrinolysis already at an ethanol level of 1 per thousand. This is the first study assessing the effects of ethanol on coagulation and fibrinolysis in a whole blood model. The impairment of coagulation is similar in nature to the impairment found in patients suffering from hypothermia. The impairment is at a level that may be of clinical importance (e.g. in patients suffering from trauma). The inhibition of fibrinolysis is obvious already at an ethanol level of 1 per thousand and it may be a contributing factor to the increased amount of coronary and cerebrovascular ischemic events after binge drinking.
authors.affiliation: Department of Anaesthesia and Intensive Care, Lund University Hospital, Lund, Sweden. martin.engstrom@med.lu.se
authors.forename: Martin
authors.initials: M
authors.lastname: Engström
authors.forename: Ulf
authors.initials: U
authors.lastname: Schött
authors.forename: Peter
authors.initials: P
authors.lastname: Reinstrup
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects; D001777:Blood Coagulation / Q000187:drug effects*; D001778:Blood Coagulation Disorders / Q000139:chemically induced; D002492:Central Nervous System Depressants / Q000009:adverse effects* / Q000097:blood; D000431:Ethanol / Q000009:adverse effects* / Q000097:blood; D005342:Fibrinolysis / Q000187:drug effects*; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D066298:In Vitro Techniques; D013916:Thrombelastography
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol