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CARDIOVASCULAR ANESTHESIA

The Effect of Hemopure® on Coagulation in Clinically Relevant Concentrations

Department of Anaesthesia, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa

Address correspondence to Michael F. James, PhD, FRCA, Department of Anaesthesia, Groote Schuur Hospital, 7925 Observatory, Cape Town, South Africa. Address e-mail to james{at}cormack.uct.ac.za Reprints will not be available from the authors.

Hemopure® is a new colloidal blood substitute that may influence coagulation. We designed this study to examine the influence of this product on in vitro coagulation of whole blood by using the thrombelastograph® (TEG®). Blood samples from 20 volunteers were obtained. Hemopure® was added to blood samples to obtain 0.5, 1, and 2 g/dL mixtures of Hemopure® in blood. Control consisted of an undiluted sample and, for comparison, two samples diluted with volumes of lactated Ringer’s solution (LR) equivalent to the two higher Hemopure® dilutions. TEG® with Hemopure® at a concentration of 2 g/dL showed significantly shorter reaction and clot formation k times and an increased angle compared with control. LR dilution with equivalent volume to 2 g/dL Hemopure® solution also resulted in significantly shorter reaction and k times, as well as an increased angle. Coagulation in samples with Hemopure® at concentrations of 0.5 and 1 mg/dL did not vary significantly from control. Maximum amplitude did not vary significantly from control in any samples. The effect of Hemopure® on TEG® measures of coagulation is not significantly different from that of LR at clinically relevant concentrations.

IMPLICATIONS: Hemopure®, a polymerized bovine hemoglobin used as a blood substitute, might interfere with coagulation. At clinically relevant in vitro dilutions of whole blood, the effects of Hemopure® on whole-blood coagulation as measured by the thrombelastograph were not significantly different from those of the carrier substance, lactated Ringer’s solution.