| JOURNAL HOME | CME HOME | THIS MONTH | PAST ISSUES | ETOC | COLLECTIONS |
| AUTHORS | REVIEWERS | EDITORIAL BOARD | FEEDBACK | RSS | HELP |
| ||||||||||||||
| ||||||||||||||
|
|
|
|
||||||||||||
|
||||||||||||||
*Department of Anesthesiology; Laboratory of Hematology; and Department of General Surgery, Hôpital Pitié-Salpêtrière, Paris, France; and Department of Anesthesiology, Hôpital Avicennes, Bobigny, France
Address correspondence and reprint requests to Catherine Huraux, Département d’Anesthésie-Réanimation, Hôpital Pitié-Salpêtrière, 47, Boulevard de l’Hôpital, 75651 Paris, Cedex 13, France. Address e-mail to catherine.huraux{at}psl.ap-hop-paris.fr
Hydroxyethyl starches (HES) interfere with coagulation because of their molecular structure and the amount infused during surgery. Coagulation defects include platelet dysfunction and a decrease of the VIII/von Willebrand factor complex (VIII/vWF). We examined the effects of 6% HES 200/0.6 on hemostasis by using an in vitro platelet function analyzer, the usual coagulation tests, the VIII/vWF complex assessment, and TEG® analysis in patients undergoing abdominal surgery. The influence of the blood group was investigated. HES infusion induced primary hemostasis alterations, assessed by a prolonged platelet function analyzer closure time in the presence of epinephrine and adenosine diphosphate, which was not correlated with the platelet count. The decrease in VIII/vWF complex was proportional to the volume of infused HES (20 and 30 mL/kg) and was more pronounced in patients of the O blood group. The preoperative hypercoagulability status assessed by TEG® analysis was reversed 24 h after HES infusion. In conclusion, 6% HES 200/0.6 induced immediate hemostasis alterations. Patients of the O blood group were likely to develop a von Willebrand-like syndrome after HES infusion. We conclude that intraoperative use of 6% HES 200/0.6 should be restricted in patients of the O blood group undergoing surgical procedures with high risk for bleeding.
Implications: A von Willebrand-like syndrome occurred immediately after 6% HES 200/0.6 infusion in patients undergoing abdominal surgery. These hemostasis alterations were more pronounced in patients of the O blood group and may suggest a restricted intraoperative use of HES in this patients population undergoing surgical procedures with a high risk for bleeding.
This article has been cited by other articles:
|
|
 |
|
  O. A. Bamgbade, P. Dorje, and M. D. Caldwell Hemostatic Impairment After Infusion of Hydroxyethyl Starch, Gelatin, and Albumin Anesth. Analg., May 1, 2007; 104(5): 1295 - 1296. [Full Text] [PDF]
|
|
|
|
|
|
J. G. Kang, H. J. Ahn, G. S. Kim, T. S. Hahm, J. J. Lee, M. S. Gwak, and S. J. Choi The Hemostatic Profiles of Patients with Type O and Non-O Blood After Acute Normovolemic Hemodilution with 6% Hydroxyethyl Starch (130/0.4) Anesth. Analg., December 1, 2006; 103(6): 1543 - 1548. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Van der Linden and B. E. Ickx The effects of colloid solutions on hemostasis: [Les effets des solutions colloides sur l'hemostase] Can J Anesth, June 1, 2006; 53(6_suppl): S30 - S39. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Arellano, B. S. Gan, M. J. Salpeter, E. Yeo, S. McCluskey, R. Pinto, J. Irish, D. C. Ross, D. J. Doyle, J. Parkin, et al. A Triple-Blinded Randomized Trial Comparing the Hemostatic Effects of Large-Dose 10% Hydroxyethyl Starch 264/0.45 Versus 5% Albumin During Major Reconstructive Surgery Anesth. Analg., June 1, 2005; 100(6): 1846 - 1853. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. E. Barron, M. M. Wilkes, and R. J. Navickis A Systematic Review of the Comparative Safety of Colloids Arch Surg, May 1, 2004; 139(5): 552 - 563. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Van der Linden, S. G. De Hert, A. Daper, A. Trenchant, D. Schmartz, P. Defrance, and P. Kimbimbi 3.5% urea-linked gelatin is as effective as 6% HES 200/0.5 for volume management in cardiac surgery patients: [La gelatine a pont d'uree a 3,5 % est aussi efficace que de l'HEA 200/0,5 a 6 % pour le remplissage vasculaire des patients de chirurgie cardiaque] Can J Anesth, March 1, 2004; 51(3): 236 - 241. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. H. Kuitunen, M. J. Hynynen, E. Vahtera, and M. T. Salmenpera Hydroxyethyl Starch as a Priming Solution for Cardiopulmonary Bypass Impairs Hemostasis After Cardiac Surgery Anesth. Analg., February 1, 2004; 98(2): 291 - 297. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. T. McCammon, J. P. Wright, M. Figueroa, and V. G. Nielsen Hemodilution with Albumin, but Not Hextend(R), Results in Hypercoagulability as Assessed by Thrombelastography(R) in Rabbits: Role of Heparin-Dependent Serpins and Factor VIII Complex Anesth. Analg., October 1, 2002; 95(4): 844 - 850. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Lisander, R. Hahn, and C. Huraux Hemostasis in Patients of Different ABO Blood Groups * Response Anesth. Analg., July 1, 2002; 95(1): 254 - 255. [Full Text] [PDF]
|
|
|
|
|
|
E. G. Pivalizza, D. C. Abramson, and C.-M. Samama Thromboelastography: Another Point of View Anesth. Analg., August 1, 2001; 93(2): 517 - 518. [Full Text] [PDF]
|
|
|
