title: Effects of in vitro hemodilution with crystalloids, colloids, and plasma on canine whole blood coagulation as determined by kaolin-activated thromboelastography.
abstract: OBJECTIVE
  To investigate the effects of in vitro hemodilution with lactated Ringers solution (LRS), hetastarch (HES), and fresh frozen plasma (FFP) on whole blood coagulation in dogs as assessed by kaolin-activated thromboelastography.
  
  
  METHODS
  In vitro experimental study.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Six healthy client-owned dogs.
  
  
  METHODS
  Whole blood was collected and diluted in vitro at a 33% and 67% dilution with either LRS, HES, or FFP.
  
  
  RESULTS
  Kaolin-activated thromboelastography was performed on each sample as well as a control. Thromboelastographic parameters R (min), alpha (deg), K (min), and MA (mm) were measured and compared to the sample control for each dilution using mixed model methodology. Prolongation in coagulation times were seen at both dilutions with LRS and HES. There was no significant difference in R times at the 33% dilution, but R time was significantly prolonged at the 67% dilution with HES (P = 0.004). MA was significantly decreased for LRS at both dilutions (P = 0.013, P < 0.001) and more profoundly decreased for HES (P < 0.001, P = 0.006). No significant difference in any parameter was found for FFP.
  
  
  CONCLUSIONS
  In vitro hemodilution of whole blood with both LRS and HES but not FFP resulted in significant effects on coagulation with HES having a more profound effect. In vivo evaluation of changes in coagulation with various resuscitation fluids is warranted and may be clinically relevant.
authors.affiliation: Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA, 01536.
authors.forename: Bari R
authors.initials: BR
authors.lastname: Morris
authors.affiliation: Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA, 01536.
authors.forename: Armelle
authors.initials: A
authors.lastname: deLaforcade
authors.affiliation: Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA, 01536.
authors.forename: Joyce
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA, 01536.
authors.forename: Joseph
authors.initials: J
authors.lastname: Palmisano
authors.affiliation: Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA, 01536.
authors.forename: Dawn
authors.initials: D
authors.lastname: Meola
authors.affiliation: Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA, 01536.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rozanski
mesh_terms: D000818:Animals; D001777:Blood Coagulation / Q000187:drug effects*; D001780:Blood Coagulation Tests / Q000662:veterinary; D003102:Colloids / Q000494:pharmacology; D000077324:Crystalloid Solutions; D004285:Dogs / Q000097:blood*; D006438:Hemodilution / Q000379:methods / Q000662:veterinary*; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology*; D007552:Isotonic Solutions / Q000494:pharmacology*; D007616:Kaolin; D008297:Male; D010952:Plasma Substitutes / Q000494:pharmacology*; D000077325:Ringer's Lactate; D013916:Thrombelastography / Q000662:veterinary
chemical_list: D003102:Colloids; D000077324:Crystalloid Solutions; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D000077325:Ringer's Lactate; D007616:Kaolin
keywords: TEG; dilutional coagulopathy; dogs; fluids