The effect of hypertonic saline dextran on whole blood coagulation.
Hypertonic saline dextran (RescueFlow) is being promoted for resuscitation from hypovolaemia following injury. We studied the in vitro effect on coagulation of serial dilutions of blood with this fluid. There was a mild procoagulant effect up to a dilution of 11% and an anticoagulant effect above this level, which rapidly increased so that coagulation was grossly deranged at a 15% dilution. Although the clinical significance of these findings is not yet known, it may suggest that for hypertonic saline dextran there is little to separate the top of the therapeutic window from the threshold of potentially serious adverse effects.
Department of Accident and Emergency, Barts and the London, Queen Mary's School of Medicine, University of London, Royal London Hospital, Whitechapel, London E1 1BB, UK. t.j.coats@qmul.ac.uk
Timothy John
TJ
Coats
Mischa
M
Heron
D000925:Anticoagulants / Q000494:pharmacology; D001777:Blood Coagulation / Q000187:drug effects*; D003029:Coagulants / Q000494:pharmacology; D003911:Dextrans / Q000008:administration & dosage / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D005440:Fluid Therapy; D006801:Humans; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage / Q000494:pharmacology*; D012965:Sodium Chloride / Q000008:administration & dosage / Q000494:pharmacology*; D013916:Thrombelastography; D013997:Time Factors
D000925:Anticoagulants; D003029:Coagulants; D003911:Dextrans; D012462:Saline Solution, Hypertonic; C104375:hypertonic saline-dextran solution; D012965:Sodium Chloride