title: Hemodilution with lactated Ringer's solution causes hypocoagulability in rabbits.
abstract: Hemodilution (HD) has been associated with hypercoagulability. It was hypothesized that HD with lactated Ringer's solution (LR) would result in hypercoagulability in rabbits. Sedated rabbits (n = 12) underwent HD with LR (40% estimated blood volume replaced with five volumes of LR) via ear vessels. Key procoagulants and anticoagulant activities were assessed prior to and 3 h after HD. Hemostatic function was assessed with the activated coagulation time and platelet-inhibited thrombelastography. Circulating tissue factor activity was much more diluted (-67.2% from baseline) than tissue factor pathway inhibitor (-45.2%) or antithrombin (-9.5%) activities after HD. HD significantly decreased factor VIII complex activity (-31.5%) more than protein C activity (-5.9%), and factor X activity (-29.2%) was more diluted than antithrombin activity. The activated coagulation time and thrombelastography demonstrated a significant decrease in hemostatic function after HD. Hemodilution with LR caused hypocoagulability in the rabbit. A greater decrease in circulating procoagulant activity than anticoagulant activity appears to be the mechanism underlying HD-mediated decreases in hemostasis.
authors.affiliation: Department of Anesthesiology, Division of Cardiothoracic Anesthesia, The University of Alabama at Birmingham, Alabama 35249-6810, USA. vance.nielsen@ccc.uab.edu
authors.forename: Vance G
authors.initials: VG
authors.lastname: Nielsen
mesh_terms: D000818:Animals; D000991:Antithrombins / Q000032:analysis; D001777:Blood Coagulation; D001778:Blood Coagulation Disorders / Q000097:blood* / Q000209:etiology; D005169:Factor VIII / Q000032:analysis; D005170:Factor X / Q000032:analysis; D006438:Hemodilution / Q000009:adverse effects*; D007552:Isotonic Solutions / Q000008:administration & dosage*; D008074:Lipoproteins / Q000097:blood; D011817:Rabbits; D000077325:Ringer's Lactate; D013916:Thrombelastography; D013925:Thromboplastin / Q000032:analysis
chemical_list: D000991:Antithrombins; D007552:Isotonic Solutions; D008074:Lipoproteins; D000077325:Ringer's Lactate; C051928:lipoprotein-associated coagulation inhibitor; D005169:Factor VIII; D005170:Factor X; D013925:Thromboplastin