JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (8) Citing Articles via Google Scholar Google Scholar Articles by Roche, A. M. Articles by Mythen, M. G. Search for Related Content PubMed PubMed Citation Articles by Roche, A. M. Articles by Mythen, M. G.

---

GENERAL ARTICLES

A Head-to-Head Comparison of the In Vitro Coagulation Effects of Saline-Based and Balanced Electrolyte Crystalloid and Colloid Intravenous Fluids

Anthony M. Roche, FRCA, MMed (Anaes)^*, Michael F. M. James, FCA (SA), FRCA, PhD, Elliott Bennett-Guerrero, MD^*, and Michael G. Mythen, FRCA, MD

*Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina; Department of Anaesthesia, University of Cape Town, Cape Town, South Africa; and Centre for Anaesthesia, University College London, Middlesex Hospital, London, United Kingdom

Address correspondence to Anthony M. Roche, Department of Anesthesiology, Duke University Medical Center, DUMC 3094, Durham, NC 27710. Address e-mail to tony.roche{at}duke.edu

Both fluid composition (e.g., type of hydroxyethyl starch) and formulation (e.g., saline or balanced salt carrier solution) may alter whole blood coagulation. We therefore enrolled 10 healthy volunteers to test ex vivo, thrombelastograph®-based blood coagulation differences of eight crystalloid and colloid solutions at 20%, 40%, and 60% dilutions. Saline and lactated Ringer's solution produced a hypercoagulable state at 20%–40% dilutions. Saline, hetastarch in saline, pentastarch in saline, tetrastarch in saline, and human albumin solutions all produced a hypocoagulable state at 60% dilution. Hetastarch in saline also produced a hypocoagulable state at 40% dilution. The larger molecular weight starches produced more intense coagulation abnormalities than the medium molecular weight compounds formulated similarly (i.e., suspended in saline or balanced salt solution). The balanced salt solutions caused fewer coagulation abnormalities, especially pentastarch in balanced salt solution. This balanced salt pentastarch preparation produced the least derangement of coagulation of the colloid solutions at all dilutions, causing hypercoagulability at the lower dilutions and minimal coagulation derangement at 60% dilution. These data support the theory that smaller molecular weight hydroxyethyl starches and colloids suspended in balanced salt solutions preserve coagulation better than large molecular weight starches and saline-based colloids, as judged by thrombelastography.

This article has been cited by other articles:

				M. Zaar, B. Lauritzen, N. H. Secher, T. Krantz, H. B. Nielsen, P. L. Madsen, and P. I. Johansson Initial administration of hydroxyethyl starch vs lactated Ringer after liver trauma in the pig Br. J. Anaesth., December 10, 2008; (2008) aen350v1. [Abstract] [Full Text] [PDF]

				D. Viuff, B. Lauritzen, A. E. Pusateri, S. Andersen, R. Rojkjaer, and P. I. Johansson Effect of haemodilution, acidosis, and hypothermia on the activity of recombinant factor VIIa (NovoSeven(R)) Br. J. Anaesth., September 1, 2008; 101(3): 324 - 331. [Abstract] [Full Text] [PDF]

				J. Boldt II. The balanced concept of fluid resuscitation Br. J. Anaesth., September 1, 2007; 99(3): 312 - 315. [Full Text] [PDF]

				R. M. Peckham, M. T. Handrigan, T. B. Bentley, M. J Falabella, A. D. Chrovian, G. L. Stahl, and G. C. Tsokos C5-blocking antibody reduces fluid requirements and improves responsiveness to fluid infusion in hemorrhagic shock managed with hypotensive resuscitation J Appl Physiol, February 1, 2007; 102(2): 673 - 680. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999