title: The effects of in vitro hemodilution with 6% hydroxyethyl starch (HES) (130/0.4) solution on thrombelastograph analysis in patients undergoing liver transplantation.
abstract: BACKGROUND
  The aim of this study was to determine the effects of in vitro hemodilution with 6% HES (130/0.4) solution on thrombelastograph(®) (TEG) parameters in whole blood samples from patients with end-stage liver disease (ESLD).
  
  
  METHODS
  Enrollment consisted of 95 patients with ESLD undergoing liver transplantation. Blood was diluted by 11%, 22%, and 33% with 6% HES (130/0.4) solution. Normal saline was used as a control diluent.
  
  
  RESULTS
  When blood was diluted by 33% with normal saline, only the reaction time (r) was increased (p < 0.0001) compared to the baseline value. When blood was diluted with 6% HES (130/0.4), 11% dilution decreased maximum amplitude (MA) (p = 0.003) compared to baseline. At 33% dilution, the r (p < 0.0001, vs. baseline) and K (p < 0.0001, vs. baseline; p < 0.0001, vs. normal saline) increased, and the MA, alpha angle, and coagulation index (p < 0.0001, vs. baseline; p < 0.0001, vs. normal saline) decreased.
  
  
  CONCLUSIONS
  Hemodilution with 6% HES (130/0.4) solution results in TEG abnormalities even with 11% hemodilution, in whole blood samples of patients with ESLD undergoing liver transplantation.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Inje University Haeundae Paik Hospital, Busan, Korea.
authors.forename: Si Ra
authors.initials: SR
authors.lastname: Bang
authors.forename: Yoon Hee
authors.initials: YH
authors.lastname: Kim
authors.forename: Gaab Soo
authors.initials: GS
authors.lastname: Kim
mesh_terms: D001777:Blood Coagulation / Q000187:drug effects*; D058625:End Stage Liver Disease / Q000601:surgery*; D005260:Female; D006438:Hemodilution; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012965:Sodium Chloride / Q000494:pharmacology; D013916:Thrombelastography; D014914:Whole Blood Coagulation Time
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D012965:Sodium Chloride