Assessment of coagulation with 6% hydroxyethyl starch 130/0.4 in cesarean section.
10.4097/kjae.2012.62.4.337
- Author:
Chung Sik OH
1
;
Tae Yun SUNG
;
Seong Hyop KIM
;
Duk Kyung KIM
;
Jeong Ae LIM
;
Nam Sik WOO
Author Information
1. Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
- Publication Type:In Vitro ; Original Article ; Randomized Controlled Trial
- Keywords:
Cesarean section;
Coagulation;
Hydroxyethyl starch;
Pregnancy
- MeSH:
Blood Coagulation;
Cesarean Section;
Female;
Hemodilution;
Hemostasis;
Hetastarch;
Pregnancy;
Reference Values
- From:Korean Journal of Anesthesiology
2012;62(4):337-342
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Third-generation hydroxyethyl starch (HES) solutions have been developed to minimize negative effects on hemostasis. In normal pregnancy, the coagulation activity increases, reaching a maximum around term. This study examined the effects of hemodilution with HES 130/0.4 (6%) on blood coagulation in parturients in vivo and in vitro. METHODS: Forty parturients scheduled for cesarean sections were assigned randomly to receive either 500 or 1,000 ml of HES 130/0.4 (6%). Rotation thromboelastometry (ROTEM(R)) measurements were performed before and after administering HES 130/0.4 (6%). In addition, blood samples obtained from 20 randomly selected parturients were diluted 10% to 40% using HES 130/0.4 (6%), and ROTEM(R) measurements were performed before and after dilution. The changes from baseline and the effects of dilution were analyzed by ROTEM(R) parameters. RESULTS: Infusions of 500 or 1,000 ml of HES 130/0.4 (6%) in the parturients altered the clot formation time, alpha angle, and maximal clot firmness, although all remained within normal ranges. HES 130/0.4 (6%) affected in vitro blood coagulation in parturients' blood containing 10, 20, 30, and 40% HES. The clotting time was prolonged at each dilution percentage, but remained within the normal range. Other parameters showed an impairment of the coagulation system. CONCLUSIONS: Blood coagulation in parturients may be compromised at high dilution ratios of HES 130/0.4 (6%) to blood. Nevertheless, the infusion of 1,000 ml of HES 130/0.4 (6%) in normal parturients did not significantly affect blood coagulation.
