4.3 Article

Effects of Acute Hypervolemic Fluid Infusion of Hydroxyethyl Starch and Gelatin on Hemostasis and Possible Mechanisms

Journal

CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS
Volume 16, Issue 1, Pages 91-98

Publisher

SAGE PUBLICATIONS INC
DOI: 10.1177/1076029608330474

Keywords

hemostasis; acute hypervolemic fluid infusion; hydroxyethyl starch; gelatin; lactated Ringer's solution; thrombelastograph

Funding

  1. Shanghai Science and Technology Development Fund, China [03ZR14046]

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Objective: The purpose of this study was to investigate the effects of acute hypervolemic fluid infusion (AHFI) of 6% hydroxyethyl starch (HES) 130/0.4 or 4% succinylated gelatin (GEL) on hemostasis and the possible mechanisms. Methods: Thirty-six gastric cancer patients were randomized to receive AHFI of either HISS, GEL or lactated Ringer's (RL) solution at the rate of 30 mL.kg(-1).h(-1) from 20 minutes before to 40 minutes after induction of general anesthesia. Results: Group HES and GEL had significantly prolonged PT and aPTT, decreased VIII:C and vWF immediately after AHFI. Statistically prolonged reaction time and coagulation time, and decreased growth angle were seen immediately after HES infusion. Maximum amplitude decreased significantly in group VIES and GEL immediately after and 4 hours after AHFI. Conclusion: Gelatin reduced Clot quality associated with derangements of fibrin polymerization and HES 130/0.4 delayed initiation of sufficient thrombin generation to convert fibrinogen to fibrin and impaired platelet function.

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