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 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 (7) Citing Articles via Google Scholar Google Scholar Articles by Boldt, J. Articles by Mengistu, A. Search for Related Content PubMed PubMed Citation Articles by Boldt, J. Articles by Mengistu, A. Related Collections Coagulation General

---

GENERAL ARTICLES

A New Plasma-Adapted Hydroxyethylstarch Preparation: In Vitro Coagulation Studies Using Thrombelastography and Whole Blood Aggregometry

From the Department of Anesthesiology and Intensive Care Medicine, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany.

Address correspondence and reprint requests to Joachim Boldt, MD, PhD, Department of Anesthesiology and Intensive Care Medicine, Klinikum der Stadt Ludwigshafen, Bremserstr. 79, D-67063 Ludwigshafen, Germany. Address e-mail to boldtj{at}gmx.net.

BACKGROUND: The lack of acceptance of hydroxyethylstarch (HES) for intravascular volume replacement is most likely due to reports of abnormal coagulation. In a blinded in vitro study, we compared the effects on hemostasis of a new HES, prepared in a balanced solution, with a conventional HES preparation and Ringer’s lactate solution.

METHODS: Blood was taken from 10 healthy young male volunteers. Blood was diluted by 10%, 30%, and 50% using either 6% HES 130/0.42 prepared in a balanced solution, a conventional nonbalanced 6% HES 130/0.4 or Ringer’s lactate solution. Rotation thrombelastography, was performed after adding two activators (thromboplastin-phospholipid to monitor the intrinsic system; tissue factor to monitor the extrinsic system). Whole blood aggregometry adding adenosine diphosphate, collagen, and thrombin receptor-activating protein was used to assess changes of platelet function.

RESULTS: Dilution of blood (30% and 50%) resulted in clot formation time that was significantly more prolonged in the nonbalanced than in the balanced HES group. In the 50% diluted sample using the unbalanced HES, maximum clot firmness was significantly more reduced than by 50% dilution using the balanced HES. In the 50% diluent using the nonbalanced HES, adenosine diphosphate-, collagen-, and thrombin receptor activating protein-induced aggregometry was more reduced than in the balanced HES group.

CONCLUSIONS: A balanced HES preparation showed fewer negative effects on thrombelastographic data and platelet aggregation than a nonbalanced HES preparation, especially when using higher degrees of dilution. Future clinical studies may show a decreased influence of balanced HES solutions on coagulation.

This article has been cited by other articles:

				J. M. Handy and N. Soni Physiological effects of hyperchloraemia and acidosis Br. J. Anaesth., June 4, 2008; (2008) aen148v1. [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]

				G. Scharbert and S. Kozek-Langenecker Limitations of In Vitro Experiments on Hydroxyethyl Starch Solutions Anesth. Analg., September 1, 2007; 105(3): 885 - 885. [Full Text] [PDF]

				J. Boldt, M. Wolf, and A. Mengistu Limitations of In Vitro Experiments on Hydroxyethyl Starch Solutions Anesth. Analg., September 1, 2007; 105(3): 885 - 886. [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