ArticleThrombosis journal2026
Impact of acid selection on thrombelastometric test results - an in-vitro cohort study.
Article in Thrombosis journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
backgroundAcidosis is common in critically ill patients and is associated with coagulopathy. The impact of different acids on coagulation remains poorly understood. Hydrochloric acid has often been used without critical evaluation. We aimed to investigate the influence of different acids and their concentrations on rotational thromboelastometry (ROTEM).
methodsIn this observational study ten, blood samples were treated with hydrochloric acid (HCl), lactic acid (C₃H₆O₃), phosphoric acid (H₃PO₄), or dihydrogen phosphate (H₂PO₄⁻) to achieve defined pH levels (7.2-6.9). Respiratory acidosis was simulated by incubation in a 20% CO₂ atmosphere. Five additional samples were exposed to varying acid concentrations. Samples were analyzed using the ROTEM EXTEM assay. Clotting time (CT), clot formation time (CFT), α-angle, maximum clot firmness (MCF), and maximum lysis (ML) were assessed.
resultsAll acids exhibited concentration-dependent effects on EXTEM parameters. HCl caused significant reductions in MCF and prolonged CFT, indicating impaired clot firmness and propagation. C
conclusionThe type of acid inducing acidosis was associated with distinct alterations in ROTEM parameters in vitro. The choice of acid should be carefully considered in experimental models and taken into account when interpreting data. Whether such effects occur in vivo remains uncertain.
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