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Low dose of hydroxyethyl starch impairs clot formation as assessed by viscoelastic devices
Linköping University, Department of Clinical and Experimental Medicine, Division of Inflammation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Immunology and Transfusion Medicine. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Chemistry.
Linköping University, Department of Clinical and Experimental Medicine, Division of Inflammation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Immunology and Transfusion Medicine.
Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
2014 (English)In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 74, no 4, 344-350 p.Article in journal (Refereed) Published
Abstract [en]

Objective. High doses of the synthetic colloid hydroxyethyl starch (HES) used for plasma expansion have been associated with impaired haemostasis and hypocoagulation. Less is known about effects on clot formation in the low haemodilutional range (less than 40%). This study evaluated the effects of low haemodilution with HES and albumin on coagulation using two different viscoelastic methods. Methods. Clot formation was studied in vitro in healthy donor blood after 10% and 30% haemodilution with 60 g/L HES 130/0.4 or 50 g/L albumin with free oscillation rheometry (FOR) and rotational thromboelastography. Results. Clotting time was not significantly affected at 10% haemodilution but was prolonged with both substances at 30% dilution (p less than 0.01-0.001). The effect was significantly more pronounced with HES than with albumin. The elasticity of the clot was slightly reduced at 10% dilution with albumin, more pronounced at 10% dilution with HES (p less than 0.05), further reduced at 30% dilution with albumin and to a still greater extent at 30% dilution with HES (p less than 0.05). With albumin the functional activity of fibrinogen was not reduced in excess of the dilutional effect. HES in contrast produced a further reduction in clot elasticity than caused by mere dilution at both 10% and 30% dilutions (p less than 0.001). Conclusions. There is an adverse effect on clot formation even at low grade haemodilution with both albumin and HES. The effect on coagulation is significantly more pronounced with HES than with albumin.

Place, publisher, year, edition, pages
Informa Healthcare , 2014. Vol. 74, no 4, 344-350 p.
Keyword [en]
Coagulation; colloids; fibrinogen; haemodilution; platelets
National Category
Clinical Medicine Basic Medicine
Identifiers
URN: urn:nbn:se:liu:diva-108934DOI: 10.3109/00365513.2014.891259ISI: 000337084600011OAI: oai:DiVA.org:liu-108934DiVA: diva2:734196
Available from: 2014-07-15 Created: 2014-07-13 Last updated: 2017-12-05

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Tynngård, NahreenBerlin, GöstaSamuelsson, AndersBerg, Sören

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Tynngård, NahreenBerlin, GöstaSamuelsson, AndersBerg, Sören
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Division of Inflammation MedicineFaculty of Health SciencesDepartment of Clinical Immunology and Transfusion MedicineDepartment of Clinical ChemistryDivision of Drug ResearchDepartment of Anaesthesiology and Intensive Care in LinköpingDivision of Cardiovascular MedicineDepartment of Thoracic and Vascular Surgery
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Scandinavian Journal of Clinical and Laboratory Investigation
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