title: Assessment of hemostaseologic alterations induced by hyperbaric oxygen therapy using point-of-care analyzers.
abstract: BACKGROUND
  Exposure to hyperbaric conditions influences the coagulation system. Thromboembolic events and disseminated intravascular coagulation were observed.
  
  
  OBJECTIVE
  To detect the effects of a hyperbaric environment on the human coagulation system using the point-of-care coagulation analyzers Multiplate and ROTEM.
  
  
  METHODS
  20 patients were included. Each received 90 minutes of oxygen intermittently at 2.4 atmospheres absolute, as per the TS 240-90 wound-healing protocol. Blood samples were taken before and after hyperbaric exposure and ROTEM, Multiplate and standard laboratory assays were subsequently performed.
  
  
  RESULTS
  ROTEM showed a significant increase of the maximum clot firmness (EXTEM MCF; p < 0.05) and the thromboelastometric platelet component of the clot firmness (MCF(EXTEM) - MCF(FIBTEM); p < 0.01). Multiplate showed a platelet activation mediated by thrombin (AU TRAP-test; p < 0.05) and by arachidonic acid (AUC ASPI-test; p < 0.01). Standard laboratory assays revealed a lower activated partial thromboplastin time (p < 0.05) and a higher leukocyte count (p < 0.05). No further changes were detected. A t-test was performed after testing if data followed normal distribution.
  
  
  CONCLUSIONS
  ROTEM and Multiplate were able to detect an activation of platelets after HBO2 therapy via thrombin and arachidonic acid pathways. Previously reported fibrinolysis could not be confirmed.
authors.forename: Enrico
authors.initials: E
authors.lastname: Monaca
authors.forename: Hartmut
authors.initials: H
authors.lastname: Strelow
authors.forename: Tobias
authors.initials: T
authors.lastname: Jüttner
authors.forename: Till
authors.initials: T
authors.lastname: Hoffmann
authors.forename: Tim
authors.initials: T
authors.lastname: Potempa
authors.forename: Joachim
authors.initials: J
authors.lastname: Windolf
authors.forename: Michael
authors.initials: M
authors.lastname: Winterhalter
mesh_terms: D019540:Area Under Curve; D001777:Blood Coagulation / Q000502:physiology*; D001780:Blood Coagulation Tests / Q000379:methods; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015539:Platelet Activation / Q000502:physiology*; D019095:Point-of-Care Systems; D013916:Thrombelastography / Q000295:instrumentation / Q000379:methods*