#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Influencing hemostasis in substitute solution treatment


Authors: J. Máca;  R. Kula;  V. Chýlek
Authors‘ workplace: Anesteziologicko‑resuscitační klinika FN Ostrava, přednosta prim. MUDr. Jan Jahoda
Published in: Vnitř Lék 2009; 55(1): 27-36
Category: Reviews

Overview

Hemostasis is an important intricately regulated homeostatic process. During the hospitalization a critically ill patient is often subjected to various external and internal stimuli which have abilities to influence the hemostasis. Administration of substitute solutions could be related to such an adverse effect. This paper tries to describe main mechanisms leading to impair the hemostatic balance during the fluid therapy and outline possibilities of their monitoring. The work also deals with every basic arteficial substitute solutions individually in term of their influence on coagulation. The goal was as well to point out certain controversial conclusions and problems emerging from the effort of synthesis of all information acquired from clinical publications related to the main topic. Generally it is possible to conclude that all substitutes have a potential to disturb coagulation. Tromboelastography belongs between the most accurate ways to measure coagulation disturbances and has several substantial advantages compared to classic examination. Character and degree of the influence depends on quantity, velocity of administration and type of used solution.

Key words:
substitute solutions – hemostasis – fluid therapy


Sources

1. Barak M, Rudin M. Fluid administration during abdominal surgery influences coagulation in the postoperative period. Curr Surg 2004; 61: 459–462.

2. Bickell WH, Bruttig SP. The detrimental effects of intravenous crystalloid after aortotomy in swine. Surgery 1991; 110: 529–536.

3. Boldt J, Haisch G, Suttner S et al. Are lactated Ringer’s solution and normal saline solution equal with regard to coagulation? Anesh Analg 2002; 94: 378–384.

4. Boldt J, Heesen M. Does the type of volume therapy influence endothelial‑related coagulation in the critically ill? Br J Anaesth 1995; 75: 740–746.

5. Boldt J, Suttner S. Plasma substitutes. Minerva Anestesiol 2005; 71: 741–758.

6. Boldt J. Volume replacement in the surgical patient – does the type of solution make a difference? Br J Anaesth 2000; 84: 783–793.

7. Brummel-Ziedins K, Whelihan MF, Ziedins EG et al. The resucitative fluid you choose may potentiate bleeding. J Trauma 2006; 61: 1350–1358.

8. Coats TJ, Brazil E, Heron M et al. Impairment of coagulation by commonly used resuscitation fluids in human volunteers. Emerg Med J 2006; 23: 846–849.

9. Cotton AC, Guy GS, Morriss JA et al. The celullar, metabolic and systemic consequences of aggresive fluid resuscitation strategies. Shock 2006; 26: 115–121.

10. Egli GA, Zollinger A. Effect of progresive haemodilution with hydroxyaethykl starch, gelatin and albumin on blood coagulation. Br J Anaesth 1997; 78: 684–689.

11. Gamsjäger T, Gustorff G. The effect of hydroxyaethy starches on intracellular calcium in platelets. Anesth Analg 2002; 95: 866–869.

12. Janvir SB, Davies G, Greenhalgh RM. Postoperative deep vein thrombosis caused by intravenous fluids during surgery. Br J Surg 1980; 67: 690–693.

13. Konrad C, Markl T. The effects of in vitro hemodilution with gelatin, hydroxyeathyl starch and lactated Ringer’s solution on markers of coagulation: an analysis using SONOCLOTTM. Anesth Analg 1999; 88: 483–488.

14. Kowalenko T, Stern S. Improved outcome with hypotensive resuscitation of uncontrolled hemorrhagic shock in a swine model. J Trauma 1992; 33: 349–353.

15. Lehmann G, Marx G, Förster H. Bio­equivalence comparison between hydoxy­ethyl starch 130/0.42/6:1 and hydroxy­ethyl starch 130/0.4/9:1. Drugs RD 2007; 8: 229–240.

16. Madjpour C, Dettori N, Frascarolo P et al. Molecular weight of hydroxyethyl starch: is there an effect on blood coagulation and pharmacokinetics? Br J Anaesth 2005; 94: 569–576.

17. Mardel SN, Saunders FM, Allen H et al. Reduced quality of clot formation with saline based plasma substitutes. Br J Anaesth 1998; 80: 204–207.

18. Mg Loughlin TM, Fontana JL. Profound normovolemic hemodilution: hemostatic effect in patients and in a porcine model. Anesth Analg 1996; 83: 459–465.

19. Mortier E, Ongenae M. In vitro evaluation of the effect of profound haemodilution with hydroxyaethyl starch 6%, modified fluid gelatin 4% and dextran 40 10% on coagulation profile measured by thromboelastography. Anaesth 1997; 52: 1061–1064.

20. Ng KF, Lam CCK. In vivo effect of haemodilution with saline on coagulation: a randomized controlled trial. Br J Anaesth 2002; 88: 475–480.

21. Ng KF, Lo JW. The development of hypercoagulability state, as measured by thromboelastography, associated with intraoperative surgical blood loss. Anaesth Intensive Care 1996; 24: 20–25.

22. Niemi TT, Kuitunen AH. Hydroxyaethyl starch impairs in vitro coagulation. Acta Anaesth Scand 1998; 42: 1104–1109.

23. Owens TM, Watson WC. Limiting initial resuscitation of uncontrolled hemor­rhage reduces internal bleeding and subsequent volume requirements. J Trauma 1995; 39: 200–207.

24. Petroianu GA, Liu J. The effect of in vitro hemodilution with gelatin, dextran, hydroxyaethyl starch, or Ringer’s solution on thromboelastograph. Anesth Analg 2000; 90: 795–800.

25. Riddez L, Johnson H. Central and regional hemodynamics during crystalloid fluid therapy after uncontrolled intra-abdominal bleeding. J Trauma 1998; 44: 433–439.

26. Roche AM, James MF, Bennet–Guerrero E et al. A head-to-head comparison of the in vitro coagulation effects of saline‑based and balanced electrolyte crystaloid and colloid intravenous fluids. Anesth Analg 2006; 102: 1274–1279.

27. Ruttman TB, Jams MF. Effects on coagulation of intravenous crystaloid or colloid in patients undergoing peripheral vascular surgery. Br J Anaesth 2002; 89: 226–230.

28. Ruttmann TG, James MFM, Aronson I. In vivo effect oh haemodilution with hydroxyethyl starch (200/0.5) and normal saline. Br J Anaesth 1998; 80: 612–616.

29. Ruttmann TG, James MFM, Viljoen JF. Haemodilution induces a hypercoagulable state. Br J Anaesth 1996; 76: 412–414.

30. Ruttmann TG, Montoya-Pelaez LF, James MF. The coagulation changes induced by rapid in vivo crystalloid infusion are attenuated when magnesium is kept at the upper limit of normal. Anesth Analg 2007; 104: 1475–1480.

31. Sommermeyer K, Cech F, Schossow R. Differences in chemical structures between waxy maize – and potato starch‑based hydroxyethyl starch volume therapies. Transfus Altern Transfus Med 2007; 9: 127–133.

32. Stephens R, Mythen M. Resuscitation fluids and hyperchloraemic metabolic acidosis. Trauma 2003; 5: 141–147.

33. Stern SA, Dronen SC. Multiple resuscitation regimens in near fatal porcine aortic injury hemorhage model. Acad Emerg Med 1995; 2: 80–81.

34. Tobias MD, Wambold D. Differential effects of serial hemodilution with hydroxyaethyl starch, albumin, and 0.9% saline on whole blood coagulation. J Clin Anesth 1998; 10: 366–371.

35. Türkan H, Ural AU. Effects of hydroxyethyl starch on blood coagulation profile. Eur J Aneaesthesiol 1999; 16: 156–159.

36. von Roten I, Madjpour C, Frascarolo Pet al. Molar substitution and C2/C6 ratio of hydroxyethyl strach: influence on blood coagulation. Br J Anaesth 2006; 96: 455–463.

37. Kula R, Chylek V, Sklienka P et al. Přínos a vybraná rizika krevních převodů. Čes Gynekol 2006; 71: 494–499.

38. Kula R, Szturz P, Sklienka P et al. Negative fluid balance in patients with abdominal compartment syndrome – Case Reports. Acta Chir Belg 2008; 108: 100–102.

39. Ruttmann TG. Haemodilution enhances coagulation. Br J Anaesth 2002; 88: 470–472.

40. Boldt J. The balanced concept of fluid resuscitation Br J Anaesth 2007; 99: 312–315.

41. Tocantins LM. Clinical and physiologic aspects of blood coagulation. Ann West Med Surg 1950; 4: 61–65.

42. Tuman KJ, Speiss BD, McCarthy RJ et al. Effects of progressive blood loss on coagulation as measured by thromboelastography. Anesth Analg 1987; 66: 856–863.

43. Ruttmann TG, James MF. Pro-coagulant effect of in vitro coagulation is not inhibited by aspirin. Br J Anaesth 1999; 83: 330–332.

Labels
Diabetology Endocrinology Internal medicine
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#