Environmental Influences on the Hemostatic Mechanism

  • Derek Ogston


Man’s quest for natural resources and his appetite for ever more arduous recreation have led to increasingly frequent exposure to extremes of pressure and temperature. In addition, the severe winters of many countries claim a high toll from accidental hypothermia, particularly in the elderly. While some of the patho-physiological effects of environmental hazards have received extensive study, their influence on the hemostatic mechanism have had relatively scant attention in spite of hints from clinical observations that hemostatic function can be altered in the presence of high ambient pressure, hypothermia and hyperthermia. This chapter reviews the available information on the influences of cold, heat, high altitude and compression-decompression on components of the hemostatic mechanism.


Disseminate Intravascular Coagulation Fibrinolytic Activity Simulated Altitude Factor Viii Level Accidental Hypothermia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Anstall, H.B. and Hawkey, CM. (1962) ‘Observations on platelet clumping and related phenomena’, Transfusion, 2, 44–51CrossRefGoogle Scholar
  2. Beard, M.E.J, and Hickton, CM. (1982) ‘Haemostasis in heat stroke’, British Journal of Haematology, 52, 269–74CrossRefGoogle Scholar
  3. Bedrak, E., Beer, G. and Furman, K.I. (1964) ‘Fibrinolytic activity and muscular exercise in heat’, Journal of Applied Physiology, 19, 469–71Google Scholar
  4. Behnke, O. (1967) ‘Some possible practical implications of the lability of blood microtubules’, Vox Sanguinis, 13,502–1CrossRefGoogle Scholar
  5. Bennett, P.B. and Gray, S.P. (1971) ‘Changes in human urine and blood chemistry during a simulated oxygen-helium dive to 1,500 feet’, Aerospace Medicine, 42, 868–74Google Scholar
  6. Bonin, B., Straub, P.W., Schibli, R. and Buhlmann, A.A. (1973) ‘Blood coagulation during critical decompression following diving experiments with oxygen/helium’, Aerospace Medicine, 44, 508–12Google Scholar
  7. Britton, B.J., Hawkey, C, Wood, W.G., Peele, M., Kaye, J. and Irving, M.H. (1974) ‘Adrenergic, coagulation, and fibrinolytic responses to heat’, British Medical Journal, 4, 139–41CrossRefGoogle Scholar
  8. Caen, J.P., Drouet, L., Bellanger, R., Michel, H. and Henon, P. (1973/74) ‘Thrombosis, platelet behaviour, fibrinolytic activity, and diet on the Andes plateau’, Haemostasis, 2, 13–20Google Scholar
  9. Chadd, M.A. and Gray, O.P. (1972) ‘Hypothermia and coagulation defects in the newborn’, Archives of Diseases in Childhood, 47, 819–21CrossRefGoogle Scholar
  10. Chohan, I.S., Singh, I. and Balakrihson, K. (1974) ‘Fibrinolytic activity at high altitude and sodium acetate buffer’, Thrombosis et Diathesis Haemorrhagica, 32, 65–70Google Scholar
  11. Cunningham, G.M., Boyde, G., Windebank, J., Moran, F. and McNicol, G.P. (1971) ‘The effect of oxygen on the fibrinolytic enzyme system’, in vivo Journal of Clinical Pathology, 24, 705–7CrossRefGoogle Scholar
  12. Dodman, B., Cunliffe, W.J., Roberts, B.E. and Buchan, C.W. (1973) ‘Effects of changes in temperature (local and central) on plasma fibrinolytic activity’, Journal of Clinical Pathology, 26, 248–9CrossRefGoogle Scholar
  13. Gray, G.W., Bryan, A.C., Freedman, M.H., Houston, C.S., Lewis, W.F., McFadden, D.M. and Newell, G. (1975) ‘Effect of altitude exposure on platelets’, Journal of Applied Physiology, 39, 648–51Google Scholar
  14. Hallenbeck, J.M., Bove, A.A., Moquin, R.B. and Elliott, D.H. (1973) ‘Accelerated coagulation of whole blood and cell-free plasma by bubbling’ in vitro, Aerospace Medicine, 44, 111Google Scholar
  15. Helmsworth, J.A., Stiles, W.J. and Elstun, W. (1955) ‘Changes in blood cellular elements in dogs during hypothermia’, Surgery, 38, 843–6Google Scholar
  16. Hoon, R.S., Sharma, S.C, Balasubramanian, V., Chadha, K.S. and Mathew, O.P. (1976) ‘Urinary catecholamine excretion on acute induction to high altitude (3,658 m)’, Journal of Applied Physiology, 41, 631–3Google Scholar
  17. Hurtado, A. (1932) ‘Studies at high altitude. Blood observations on the Indian natives of the Peruvian Andes’, American Journal of Physiology, 100, 487–505Google Scholar
  18. Jacey, M.J., Gonzales, A. and Tappan, D.V. (1977) ‘Hematologic changes after two exposures to 6.7 ATA air at three-day intervals’, Journal of Applied Physiology, 42, 838–44Google Scholar
  19. Johansson, B.W. and Nilsson, I.M. (1964) ‘The effect of heparin and e-aminocaproic acid on the coagulation in hypothermic dogs’, Acta Physiologica Scandinavica, 60, 267–77CrossRefGoogle Scholar
  20. Kattlove, H.E. and Alexander, B. (1974) ‘The effect of cold on platelets. 1. Cold-induced platelet aggregation’, Blood, 38, 39–48Google Scholar
  21. Kattlove, H.E., Alexander, B. and White, F. (1972) ‘The effect of cold on II. Platelet function after short-term storage at room temperature’, Blood, 40, 688–96Google Scholar
  22. Maker, J.T., Levine, P.H. and Clymerman, A. (1976) ‘Human coagulation abnormalities during acute exposure to hyperbaric hypoxia’, Journal of Applied Physiology, 41, 702–7Google Scholar
  23. Malhotra, M.S., Selvamurthy, W., Purkayastha, S.S., Mukherjee, A.K., Mathew, L. and Dua, G.L. (1976) ‘Responses of the autonomic nervous system during acclimatization to high altitude in man’, Aviation, Space, and Environmental Medicine, 47, 1076–9Google Scholar
  24. Martin, K.J. and Nichols, G. (1972) ‘Observations on platelet changes in man after simulated diving’, Aerospace Medicine, 43, 827–30Google Scholar
  25. Meikle, A.W. and Graybill, J.R. (1967) ‘Fibrinolysis and hemorrhage in a fatal case of heat stroke’, New England Journal of Medicine, 276, 911–3CrossRefGoogle Scholar
  26. Ogston, D. and Taylor, A.K.M. (1981) ‘The effect of heat on platelet aggregation’, Journal of Physiology, 310, 71–2PGoogle Scholar
  27. Philp, R.B., Inwood, M.J. and Warren, B.A. (1972a) ‘Interactions between gas bubbles and components in the blood: implictions in decompression sickness’, Aerospace Medicine, 43, 946–53Google Scholar
  28. Philp, R.B., Ackles, K.N., Inwood, M.J., Livingstone, S.D., Achimastos, A., Binns-Smith, M. and Radomski, M.W. (1972b) ‘Changes in the hemostatic system and in blood and urine chemistry of human subjects following decompression from a hyperbaric environment’, Aerospace Medicine, 43, 498–505Google Scholar
  29. Philp, R.B., Inwood M.J., Ackles, K.N. and Radomski, M.W. (1974) ‘Effects of decompression on platelets and haemostasis in men and the influence of antiplatelet drugs (RA 233 and VK 744)’, Aerospace Medicine, 45, 231–40Google Scholar
  30. Pina-Cabral, J.M., Amaral, I., Macedo Pinto, M. and Guerra e Paz, L.H. (1973/74) ‘Hepatic and splenic platelet sequestration during deep hypothermia in the dog’, Haemostasis, 2, 235–44Google Scholar
  31. Sharma, S.C. (1980a) ‘Platelet count in temporary residents of high altitude’, Journal of Applied Physiology, 49, 1047–8Google Scholar
  32. Sharma, S.C. (1980b) ‘Platelet count on acute induction to high altitude’, Thrombosis and Haemostasis, 43, 24Google Scholar
  33. Sharma, S.C. and Hoon, R.S. (1978) ‘Platelet adhesiveness on acute induction to high altitude’, Thrombosis Research, 13, 725–32CrossRefGoogle Scholar
  34. Singh, I. and Chohan, I.S. (1972a) ‘Abnormalities of blood coagulation at high altitude’, Journal of Biometeorology, 16, 283–97CrossRefGoogle Scholar
  35. Singh, I. and Chohan, I.S. (1972b) ‘Blood coagulation changes at high altitude predisposing to pulmonary hypertension’, British Heart Journal, 34, 611–7CrossRefGoogle Scholar
  36. Singh, L. and Chohan, I.S. (1974) ‘Adverse changes in fibrinolysis, blood coagulation and platelet function in high altitude pulmonary oedema and their role in its pathogenesis’, Journal of Biometeor ology, 18, 33–45CrossRefGoogle Scholar
  37. Sohal, R.S. Sun, S.C, Colcolough, H.L. and Burch, G.E. (1968) ‘Heat stroke. An electron microscopic study of endothelial cell damage and disseminated intravascular coagulation’, Archives of Internal Medicine, 122, 43–7CrossRefGoogle Scholar
  38. Stefanini, M. and Spicer, D.D. (1971) ‘Hemostatic breakdown, fibrinolysis, and acquired hemolytic anemia in a patient with fatal heatstroke’, American Journal of Clinical Pathology, 55, 180–6Google Scholar
  39. Valeri, CR., Feingold, H., Zaroulis, CG., Sphar, R.L. and Adams, G.M. (1974) ‘Effects of hyperbaric exposure on human platelets’, Aerospace Medicine, 45, 610–6Google Scholar
  40. Villalobos, T.J., Adeson, E. and Barila, T.G. (1955) ‘Hematologic changes in hypothermic dogs’, Proceedings of the Society for Experimental Biology and Medicine, 89, 192–6Google Scholar
  41. Weatherley, CR., Oxley, A., Jones, P. and Walder, D.N. (1977) ‘Haematological studies following hyperbaric exposure’, Proceedings of the 6th International Congress on Hyperbaric Medicine, Aberdeen University Press, pp. 140–5Google Scholar
  42. Weber, M.B. and Blakely, J.A. (1969) ‘The haemorrhagic diathesis of heatstroke’, Lancet, i, 1190–2Google Scholar
  43. Wensel, R.H. and Bigelow, W.G. (1959) ‘The use of heparin to minimize thrombocytopenia and bleeding tendency during hypothermia’, Surgery, 45, 223–8Google Scholar
  44. White, J.G. (1968) ‘Effects of heat on platelet structure and function’, Blood, 32, 324–35Google Scholar
  45. White, J.G. and Krivit, W. (1967) ‘An ultrastructural basis for the shape changes induced in platelets by chilling’, Blood, 30, 625–35Google Scholar
  46. Willson, J.T., Miller, W.R. and Eliot, T.S. (1958) ‘Blood studies in the hypothermic dog’, Surgery, 43, 979–89Google Scholar
  47. Zucker, M.B. and Borrelli, J. (1954) ‘Reversible alteration in platelet morphology produced by anticoagulants and by cold’, Blood, 9, 602–8Google Scholar
  48. Zucker, M.B. and Borrelli, J. (1960) ‘Viscous metamorphosis produced by chilling and clotting’, Thrombosis et Diathesis Haemorrhogica, 4, 424–34Google Scholar

Copyright information

© Derek Ogston 1983

Authors and Affiliations

  • Derek Ogston
    • 1
  1. 1.University of AberdeenUK

Personalised recommendations