Changes in Thromboelastographic Findings after Bleeding-Induced Hemodilution in Patients Undergoing Radical Hysterectomy.
10.4097/kjae.2005.49.1.11
- Author:
Jaemin LEE
1
;
Chul Soo PARK
;
Yong Suk KIM
Author Information
1. Department of Anesthesiology, School of Medicine, The Catholic University of Korea, Seoul, Korea. p6c8s17@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
coagulation;
hemodilution;
radical hysterectomy;
thromboelastograph
- MeSH:
Anesthesia;
Blood Coagulation Factors;
Blood Volume;
Fibrinolysis;
Hemodilution*;
Humans;
Hysterectomy*
- From:Korean Journal of Anesthesiology
2005;49(1):11-17
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Recent studies have produced conflicting results on the influence of hemodilution on the coagulation system. Furthermore, only a few clinical studies have been conducted regarding actual blood loss and associated hemodilution. The purpose of this study was to investigate changes in thromboelastograph (TEG) findings after moderate bleeding-induced hemodilution in patients undergoing radical hysterectomy. METHODS: 23 patients scheduled for radical hysterectomy were included. No patient had a preoperative coagulation abnormality or was receiving anticoagulant or antiplatelet medication. TEG findings 15 min after induction of anesthesia and after an estimated blood loss equaling 15% of the estimated blood volume were compared. Only crystalloid solution was administered until the second blood sampling for TEG analysis in order to produce a hemodilution state. RESULTS: After hemodilution R time, K time and coagulation time (r + k) showed significant reductions, and alpha angle and TEG index showed significant increases (P < 0.01), and increased coagulability. MA increased after hemodilution, but this was not statistically significant. A60 and CL60 also increased, showing decreased fibrinolysis (P < 0.05). CONCLUSIONS: Moderate bleeding-induced hemodilution increased coagulability according to TEG compared to pre-hemodilution findings. We recommend that the decision to replace coagulation factors and/or platelets should not be based on empirically derived, arbitrary standards.
