title: Moderate plasma dilution using artificial plasma expanders shifts the haemostatic balance to hypercoagulation.
abstract: Artificial plasma expanders (PEs) are widely used in modern transfusion medicine. PEs do not contain components of the coagulation system, so their infusion in large volumes causes haemodilution and affects haemostasis. However, the existing information on this effect is contradictory. We studied the effect of the very process of plasma dilution on coagulation and tested the hypothesis that moderate dilution with a PE should accelerate clotting owing to a decrease in concentration of coagulation inhibitors. The standard clotting times, a thrombin generation test, and the spatial rate of clot growth (test of thrombodynamics) were used to assess donor plasma diluted in vitro with various PEs. The pH value and Ca+2concentration were maintained strictly constant in all samples. The effect of thrombin inhibitors on dilution-induced hypercoagulation was also examined. It was shown that coagulation was enhanced in plasma diluted up to 2.0-2.5-fold with any PE. This enhancement was due to the dilution of coagulation inhibitors in plasma. Their addition to plasma or PE could partially prevent the hypercoagulation shift.
authors.affiliation: National Scientific and Practical Centre of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev, Russian Ministry of Health, Samory Mashela str. 1, GSP-7, Moscow, 117198, Russia. sinaurid@list.ru.|Center for Theoretical Problems of Physicochemical Pharmacology, Russian Academy of Sciences, Kosygina str. 4, Moscow, 119334, Russia. sinaurid@list.ru.
authors.forename: Elena I
authors.identifier: http://orcid.org/0000-0002-5948-3444
authors.initials: EI
authors.lastname: Sinauridze
authors.affiliation: National Research Center for Hematology, Ministry of Health, Novyi Zykovskii pr. 4, Moscow, 125167, Russia.
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Gorbatenko
authors.affiliation: National Scientific and Practical Centre of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev, Russian Ministry of Health, Samory Mashela str. 1, GSP-7, Moscow, 117198, Russia.
authors.forename: Elena A
authors.initials: EA
authors.lastname: Seregina
authors.affiliation: National Scientific and Practical Centre of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev, Russian Ministry of Health, Samory Mashela str. 1, GSP-7, Moscow, 117198, Russia.|Center for Theoretical Problems of Physicochemical Pharmacology, Russian Academy of Sciences, Kosygina str. 4, Moscow, 119334, Russia.
authors.forename: Elena N
authors.initials: EN
authors.lastname: Lipets
authors.affiliation: National Scientific and Practical Centre of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev, Russian Ministry of Health, Samory Mashela str. 1, GSP-7, Moscow, 117198, Russia.|Center for Theoretical Problems of Physicochemical Pharmacology, Russian Academy of Sciences, Kosygina str. 4, Moscow, 119334, Russia.|Department of Physics, Moscow State University, Leninskie Gory 1, building 2, Moscow, 119991, Russia.
authors.forename: Fazoil I
authors.initials: FI
authors.lastname: Ataullakhanov
mesh_terms: D001777:Blood Coagulation / Q000187:drug effects*; D002118:Calcium / Q000378:metabolism; D006801:Humans; D010952:Plasma Substitutes / Q000009:adverse effects / Q000494:pharmacology*; D013917:Thrombin / Q000037:antagonists & inhibitors / Q000378:metabolism
chemical_list: D010952:Plasma Substitutes; D013917:Thrombin; D002118:Calcium