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Changes in the haemostatic system after thermoneutral and hyperthermic water immersion

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Abstract

Warm water bathing is a popular recreational activity and is frequently used in rehabilitation medicine. Although well tolerated in most cases, there are reports indicating an increased risk of thrombotic events after hot tub bathing. The effects of a 45 min thermoneutral bath followed by a 50 min bath with increasing water temperature (maximum 41°C) until reaching a body core temperature of 39°C on factors of blood coagulation and fibrinolysis were studied in eight healthy male volunteers. Blood was obtained after a 45-min resting period as control and after the thermoneutral and hyperthermic bath as well as after another 45 min recovery period at the end of the study. Hyperthermic immersion (HI) lead to a shortening of activated partial thromboplastin time (aPTT) (P < 0.05). Fibrinogen concentration decreased immediately after HI (P < 0.05) but increased during recovery (P < 0.05). Plasminogen activator inhibitor (PAI) activity decreased during HI (P < 0.05), D-dimer concentration was not found to change. Thrombocyte count increased (P < 0.05) during HI. The increases in tissue-type plasminogen activator concentration as well as leucocyte count during HI were due to haemoconcentration. Prothrombin time, PAI-activity and granulocyte count decreased during thermoneutral immersion (P < 0.05). Warm water bathing leads to haemoconcentration and minimal activation of coagulation. The PAI-1 activity is decreased. A marked risk for thrombotic or bleeding complications during warm water bathing in healthy males could not be ascertained.

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Acknowledgments

The authors gratefully acknowledge K. Thorndike and R. Meier-Buttermilch for their support in conducting this study.

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Authors and Affiliations

  1. Department of Physiology, Center for Space Medicine Berlin, Charité, University Medicine Berlin, Campus Benjamin Franklin, Arnimallee 22, 14195, Berlin, Germany

    Leif-Hendrik Boldt, Waltraud Fraszl, Mathias Steinach, Thilo Noack & Hanns-Christian Gunga

  2. Department of Cardiology, Campus Virchow Clinic, Charité, University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Leif-Hendrik Boldt

  3. Labor 28, Mecklenburgische Straße 28, 14197, Berlin, Germany

    Lothar Röcker

  4. Department of Nephrology Campus Virchow Clinic, Charité, University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Jörg Christian Schefold

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  1. Leif-Hendrik Boldt
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Correspondence to Leif-Hendrik Boldt.

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Boldt, LH., Fraszl, W., Röcker, L. et al. Changes in the haemostatic system after thermoneutral and hyperthermic water immersion. Eur J Appl Physiol 102, 547–554 (2008). https://doi.org/10.1007/s00421-007-0620-7

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