title: The effects of haemodilution with hydroxyethyl starch 130/0.4 solution on coagulation as assessed by thromboelastography and platelet receptor function studies in vitro.
abstract: This study evaluated the effects of haemodilution with either 6% hydroxyethyl starch (HES) 130/0.4 (Voluven(®)) or 0.9% normal saline (NS) on blood coagulation in vitro. Haemodilution with 6% HES 130/0.4 impaired coagulation, as indicated by the changes in thromboelastographic parameters k-time, α-angle and maximum amplitude. Light transmission aggregometry and multiple electrode aggregometry demonstrated that impaired platelet receptor function occurred only at high levels of haemodilution (40%) with both fluids, but there was no significant difference between the two fluids (P=0.05). The thromboelastographic functional fibrinogen assay showed that the fibrinogen component of clot strength was significantly impaired with haemodilution with HES 130/0.4 compared with haemodilution with NS (whole blood [14.4 ± 4.6 mm] versus 40% HES dilution [3.7 ± 1.9], [P=0.001]; versus 40% NS dilution [10.4 ± 4.6], [P=0.129]). These findings suggest that there is little difference between HES or NS in relation to coagulation or platelet function during minor or moderate haemodilution, but at high levels of haemodilution with HES, fibrinogen activity is more impaired compared with NS.
authors.affiliation: Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, New South Wales.
authors.forename: P
authors.initials: P
authors.lastname: Williams
authors.affiliation: Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, New South Wales.
authors.forename: K
authors.initials: K
authors.lastname: Yang
authors.affiliation: Department of Haematology, Royal Prince Alfred Hospital, Camperdown, New South Wales.
authors.forename: G
authors.initials: G
authors.lastname: Kershaw
authors.affiliation: Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, New South Wales.
authors.forename: G
authors.initials: G
authors.lastname: Wong
authors.affiliation: Department of Haematology, Royal Prince Alfred Hospital, Camperdown, New South Wales.
authors.forename: S
authors.initials: S
authors.lastname: Dunkley
authors.affiliation: Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, New South Wales.
authors.forename: P C A
authors.initials: PC
authors.lastname: Kam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001777:Blood Coagulation / Q000187:drug effects*; D001792:Blood Platelets / Q000502:physiology*; D005260:Female; D006438:Hemodilution; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D010952:Plasma Substitutes / Q000494:pharmacology*; D012996:Solutions; D013916:Thrombelastography / Q000379:methods*
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D012996:Solutions
keywords: coagulation; fibrinogen; hydroxyethyl starch 130/0.4; light transmission aggregometry; multiple electrode aggregometry; platelet function; thromboelastography