Effects of acute hypervolemic fluid infusion of hydroxyethyl starch and gelatin on hemostasis and possible mechanisms.
OBJECTIVE
The purpose of this study was to investigate the effects of acute hypervolemic fluid infusion (AHFI) of 6% hydroxyethyl starch (HES) 130/0.4 or 4% succinylated gelatin (GEL) on hemostasis and the possible mechanisms.


METHODS
Thirty-six gastric cancer patients were randomized to receive AHFI of either HES, GEL or lactated Ringer's (RL) solution at the rate of 30 mL x kg(-1) x h( -1) from 20 minutes before to 40 minutes after induction of general anesthesia.


RESULTS
Group HES and GEL had significantly prolonged PT and aPTT, decreased VIII:C and vWF immediately after AHFI. Statistically prolonged reaction time and coagulation time, and decreased growth angle were seen immediately after HES infusion. Maximum amplitude decreased significantly in group HES and GEL immediately after and 4 hours after AHFI.


CONCLUSIONS
Gelatin reduced clot quality associated with derangements of fibrin polymerization and HES 130/0.4 delayed initiation of sufficient thrombin generation to convert fibrinogen to fibrin and impaired platelet function.
Jin
Shan-Liang
SL
Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yu
Bu-Wei
BW
D000328:Adult; D000768:Anesthesia, General; D001780:Blood Coagulation Tests; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001792:Blood Platelets / Q000502:physiology; D001810:Blood Volume / Q000187:drug effects; D005260:Female; D005337:Fibrin / Q000378:metabolism; D005440:Fluid Therapy; D005743:Gastrectomy; D005780:Gelatin / Q000008:administration & dosage*; D006487:Hemostasis / Q000187:drug effects*; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage*; D007552:Isotonic Solutions / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010952:Plasma Substitutes / Q000008:administration & dosage*; D000077325:Ringer's Lactate; D013274:Stomach Neoplasms / Q000097:blood* / Q000601:surgery*; D013386:Succinates / Q000008:administration & dosage*; D013916:Thrombelastography / Q000187:drug effects; D013917:Thrombin / Q000378:metabolism
D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D000077325:Ringer's Lactate; D013386:Succinates; C060085:succinylated gelatin; D005780:Gelatin; D005337:Fibrin; D013917:Thrombin