Changes in the haemostatic system after thermoneutral and hyperthermic water immersion

Authors: Boldt LH (1,2) , Fraszl W (1) , Röcker L (3) , Schefold JC (4) , Steinach M (1) , Noack T (1) , Gunga HC (1)
(1) Department of Physiology, Center for Space Medicine Berlin, Charité, University Medicine Berlin, Campus Benjamin Franklin (2) Department of Cardiology, Campus Virchow Clinic, Charité, University Medicine Berlin (3) Labor 28 (4) Department of Nephrology Campus Virchow Clinic, Charité, University Medicine Berlin
Source: Eur J Appl Physiol. 2008 Mar;102(5):547-54
DOI: 10.1007/s00421-007-0620-7 Publication date: 2008 Mar E-Publication date: Nov. 28, 2007 Availability: abstract Copyright: Not specified
Language: English Countries: Not specified Location: Not specified Correspondence address:


Article abstract

Warm water bathing is a popular recreational activity and is frequently used in rehabilitation medicine. Although well tolerated in most cases, there are reports indicating an increased risk of thrombotic events after hot tub bathing. The effects of a 45 min thermoneutral bath followed by a 50 min bath with increasing water temperature (maximum 41 degrees C) until reaching a body core temperature of 39 degrees C on factors of blood coagulation and fibrinolysis were studied in eight healthy male volunteers. Blood was obtained after a 45-min resting period as control and after the thermoneutral and hyperthermic bath as well as after another 45 min recovery period at the end of the study. Hyperthermic immersion (HI) lead to a shortening of activated partial thromboplastin time (aPTT) (P < 0.05). Fibrinogen concentration decreased immediately after HI (P < 0.05) but increased during recovery (P < 0.05). Plasminogen activator inhibitor (PAI) activity decreased during HI (P < 0.05), D-dimer concentration was not found to change. Thrombocyte count increased (P < 0.05) during HI. The increases in tissue-type plasminogen activator concentration as well as leucocyte count during HI were due to haemoconcentration. Prothrombin time, PAI-activity and granulocyte count decreased during thermoneutral immersion (P < 0.05). Warm water bathing leads to haemoconcentration and minimal activation of coagulation. The PAI-1 activity is decreased. A marked risk for thrombotic or bleeding complications during warm water bathing in healthy males could not be ascertained.

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