title: Effect of rapid fluid resuscitation using crystalloids or colloids on hemostasis in piglets.
abstract: OBJECTIVE
  Impairment of blood coagulation is one of the main side effects of volume replacement, particularly if artificial colloids such as hydroxyethyl starch (HES) and gelatine preparations are used. This animal study aimed to evaluate the effect of a single fast intravenous crystalloid or colloid fluid bolus on blood coagulation as measured by rotation thromboelastometry (ROTEM).
  
  
  METHODS
  Thirty-two anesthetized piglets were infused with a rapid 20 ml·kg(-1) fluid bolus of either normal saline (NS), 4% gelatine, 5% albumin or 6% HES 130/0.4 (n = 8 per group) over a period of 2 min. Hemostasis was assessed by ROTEM before and 1 min after fluid administration. Within-group differences were analyzed by Wilcoxon test, and additionally overall Kruskal-Wallis test followed by posthoc Mann-Whitney U-test were applied to detect differences between groups.
  
  
  RESULTS
  All fluids caused a significant weakening of clot strength within groups. HES and gelatine showed a significantly stronger impairment of clot growth and maximum clot firmness as compared with albumin and normal saline. Impairment of fibrin polymerization was more pronounced following HES as compared with all other fluids.
  
  
  CONCLUSIONS
  After moderate but very fast volume loading, HES and gelatine impair blood coagulation to a larger extent as compared with albumin or normal saline, while no significant differences were observed between both artificial colloids.
authors.affiliation: Department of Anaesthesia, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Mauch
authors.forename: Caveh
authors.initials: C
authors.lastname: Madjdpour
authors.forename: Annette P N
authors.initials: AP
authors.lastname: Kutter
authors.forename: Nelly
authors.initials: N
authors.lastname: Spielmann
authors.forename: Regula
authors.initials: R
authors.lastname: Bettschart-Wolfensberger
authors.forename: Markus
authors.initials: M
authors.lastname: Weiss
authors.forename: Thorsten
authors.initials: T
authors.lastname: Haas
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D001776:Blood Circulation Time; D001777:Blood Coagulation / Q000502:physiology; D003102:Colloids / Q000627:therapeutic use*; D000077324:Crystalloid Solutions; D005337:Fibrin; D005440:Fluid Therapy; D005780:Gelatin / Q000627:therapeutic use; D006487:Hemostasis / Q000502:physiology*; D006895:Hydroxyethyl Starch Derivatives / Q000627:therapeutic use; D007552:Isotonic Solutions / Q000627:therapeutic use*; D010952:Plasma Substitutes / Q000627:therapeutic use*; D012151:Resuscitation; D013552:Swine; D013916:Thrombelastography
chemical_list: D003102:Colloids; D000077324:Crystalloid Solutions; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D005780:Gelatin; D005337:Fibrin