| Hypothermia also has negative effects on the clotting cascade by exacerbating or precipitating traumatic coagulopathy. The body's clotting cascade is sensitive to pH and temperature. For every degree point between 89 degrees F and 93 degrees F, the body loses 10% of function of the clotting cascade. [15] As the hypothermic state is allowed to persist, the rate of bleeding increases dramatically secondary to the negative effect on the clotting cascade. Specific clotting factors and enzymes are negatively impacted by hypothermia, specifically the enzymes that are responsible for activation of thrombin, which is essential to the formation of a fibrin clot. [15] Thrombin is an element of the clotting cascade that triggers the conversion of fibrinogen into fibrin. The combination of fibrin, platelets, and red blood cells forms a clot to stop bleeding from an injured vessel. [24] Lack of adequate thrombin can make it difficult if not impossible for the body to form a clot and stop the bleeding before the patient dies from exsanguination. [24] | |
