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Effects of Stress-Hemoconcentration on the Coagulation Cascade

Austin, Anthony W.
http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1316632604

Abstract Details

2011, Doctor of Philosophy (PhD), Ohio University, Experimental Psychology (Arts and Sciences).
Objective: When examining the effects of acute psychological stress on coagulation responses, researchers have typically used the Dill and Costill (1974) mathematical correction to adjust for stress-induced plasma volume shifts. While the correction is appropriate for adjusting concentrations of large blood constituents, it may be inappropriate for time dependent or functional coagulation assays. Two novel plasma reconstitution techniques for correcting hemoconcentration effects on stress-induced coagulation changes were compared to the Dill and Costill correction. Methods: Blood was collected from 40 men during the last minute of a 20-minute baseline period, a 6-minute mental arithmetic stressor and a 20-minute recovery period. For the reconstitution techniques, stressor plasma samples were reconstituted with either the person's own plasma from baseline or physiological saline such that plasma volume at stress became equal to plasma volume at baseline. Results: Plasma volume increased significantly from baseline to stress, but returned to baseline levels at recovery. Uncorrected activated partial thromboplastin time (APTT) decreased, whereas Factor VII clotting activity (FVII:C), FVIII:C, prothrombin time (PT%), and fibrinogen concentration increased significantly from baseline to stress. Arithmetic correction produced a significantly greater decrease in APTT during stress compared to uncorrected APTT, whereas FVII:C, PT%, and fibrinogen concentration were not significantly different from baseline after arithmetic correction. Arithmetic correction had no effect on FVIII:C. After saline reconstitution, APTT, PT%, FVII:C, and fibrinogen concentration were no longer significantly different from baseline, but FVIII:C remained elevated. After plasma reconstitution, fibrinogen was not significantly different from baseline, whereas FVII:C, FVIII:C, APTT and PT% were unchanged. Though D-dimer concentration increased in the expected direction from baseline to stress, this change was non-significant. D-dimer concentration was not significantly different from baseline after each plasma volume correction technique. With the exception FVIII:C, coagulation parameters returned to baseline levels at recovery. Conclusions: The baseline plasma reconstitution method does not seem to be a useful hemoconcentration correction technique, as the Dill and Costill formula adjusts equally well. The saline reconstitution method may be a more biologically pertinent correction technique when examining stress-hemoconcentration effects on clotting time and clotting activity, whereas the Dill and Costill formula does not seem appropriate. With the exception of FVIII:C, hemoconcentration appears to account for most of the stress-induced changes in coagulation parameters examined in this study. Given that stress-induced increases of FVIII:C survived all hemoconcentration correction techniques, the intrinsic pathway of the coagulation system appears to be actually activated during acute stress. Stress-induced changes in coagulation are a consequence of both hemoconcentration and actual activation of the coagulation system.
Stephen Patterson (Committee Chair)
Bruce Carlson (Committee Member)
Julie Suhr (Committee Member)
Christopher France (Committee Member)
Michael Kushnick (Committee Member)
167 p.
Physiology; Psychobiology; Psychology
acute psychological stress; coagulation; hemostasis; hemoconcentration

Recommended Citations

Citations

  • Austin, A. W. (2011). Effects of Stress-Hemoconcentration on the Coagulation Cascade [Doctoral dissertation, Ohio University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1316632604

    APA Style (7th edition)

  • Austin, Anthony. Effects of Stress-Hemoconcentration on the Coagulation Cascade. 2011. Ohio University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1316632604.

    MLA Style (8th edition)

  • Austin, Anthony. "Effects of Stress-Hemoconcentration on the Coagulation Cascade." Doctoral dissertation, Ohio University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1316632604

    Chicago Manual of Style (17th edition)

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This open access ETD is published by Ohio University and OhioLINK.