In Vitro Coagulation Study of Hemodiluted Blood with Hydroxyethyl Starch by Thromboelastography.
10.4097/kjae.2000.38.5.800
- Author:
Sang Oh LEE
1
;
Seung Han LEE
;
Chul Hoi HUR
;
Mun Chul KIM
;
Kang Hee CHO
Author Information
1. Department of Anesthesiology, College of Medicine, In Je University, Seoul, Korea.
- Publication Type:In Vitro ; Original Article
- Keywords:
Blood: coagulation;
hemodilution;
thromboelastography;
Fluid: hydroxyethyl starch
- MeSH:
Blood Coagulation;
Colloids;
Hemodilution;
Humans;
Starch*;
Thrombelastography*;
Volunteers
- From:Korean Journal of Anesthesiology
2000;38(5):800-804
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: To avoid the risks associated with transfusion of homologous blood products, artificial colloid solutions represent an alternative for intra-operative blood loss replacement. However, synthetic colloids have been implicated as a cause of coagulopathy when administered in large quantities. We investigated the effect of Hydroxyethyl starch (HES) on blood coagulation in vitro under thromboelastography (TEG). METHODS: Whole blood was withdrawn from fifteen volunteers undergoing peripheral surgery who had no history of coagulation defect. Whole blood was diluted with HES to 25, 50 and 75 vol% concentrations, and the changes in coagulation status were analysed using TEG and were compared with those of an undiluted control specimen obtained concurrently from the same patients. RESULTS: Hemodilution with HES solution at 50 vol% concentration decreased the MA and alpha angle values (P < 0.05), but the R and K values remained unchanged. In case of profound hemodilution at a 75 vol% concentration, the values of MA and alpha angle were severely decreased (P < 0.05) and the values of R and K were severely increased (P < 0.05). CONCLUSIONS:There were many reports that moderate hemodilution with crystalloids increased coagulability, but hemodilutions up to 50 vol% concentration with HES solution did not significantly change blood coagulability. Significant hypocoagulability occurred at a 75 vol% hemodilution with HES.
