The effect of civil and military flights on coagulation, fibrinolysis and blood flow: insight from a rat model
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RESEARCH
Open Access
The effect of civil and military flights on coagulation, fibrinolysis and blood flow: insight from a rat model Anna Levkovsky1,2†, Rima Dardik3†, Daniel Barazany4, David M. Steinberg5, Mark Dan Kirichenko4, Sara Apter6,7, Edna Peleg2,8, Daniel Silverberg2,9, Ehud Grossman2,10† and Ophira Salomon1,2*†
Abstract Background: Air travel thrombosis continues to be a controversial topic. Exposure to hypoxia and hypobaric conditions during air travel is assumed a risk factor. The aim of this study is to explore changes in parameters of coagulation, fibrinolysis and blood flow in a rat model of exposure to hypobaric conditions that imitate commercial and combat flights. Methods: Sixty Sprague-Dawley male rats, aged 10 weeks, were divided into 5 groups according to the type and duration of exposure to hypobaric conditions. The exposure conditions were 609 m and 7620 m for 2 and 12 h duration. Blood count, thrombin– antithrombin complex, D-dimer, interleukin-1 and interleukin-6 were analyzed. All rats went through flight angiography MRI at day 13-post exposure. Results: No effect of the various exposure conditions was observed on coagulation, fibrinolytic system, IL-1 or IL-6. MRI angiography showed blood flow reduction in lower limb to less than 30% in 50% of the rats. The reduction in blood flow was more pronounced in the left vessel than in the right vessel (p = 0.006, Wilcoxon signed rank test). The extent of occlusion differed across exposure groups in the right, but not the left vessel (p = 0.002, p = 0.150, respectively, Kruskal-Wallis test). However, these differences did not correlate with the exposure conditions. Conclusion: In the present rat model, no clear correlation between various hypobaric conditions and activation of coagulation was observed. The reduction in blood flow in the lower limb also occurred in the control group and was not related to the type of exposure. Keywords: D-dimer, Hypobaric conditions, IL-6, MRI, Thrombin–antithrombin
* Correspondence: [email protected] † Anna Levkovsky, Rima Dardik, Ehud Grossman and Ophira Salomon contributed equally to this work. 1 Thrombosis Unit Sheba Medical Center, Coagulation Institute, 52621 Tel Hashomer, Israel 2 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regula
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