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Effects of PentaLyte ® and Voluven ® hemodilution on plasma coagulation kinetics in the rabbit: role of thrombin‐fibrinogen and factor XIII‐fibrin polymer interactions
Author(s) -
Nielsen V. G.
Publication year - 2005
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2005.00851.x
Subject(s) - fibrin , hydroxyethyl starch , fibrinogen , thrombin , coagulation , factor xiii , medicine , hemostasis , thrombelastography , chemistry , anesthesia , platelet , immunology
Background: Hydroxyethyl starch (HES) administration has resulted in decreased hemostasis and fibrinogen (FI)‐thrombin‐(FIIa)‐Factor XIII (FXIII) interactions. I proposed to determine the hemostatic effect of hemodilution with PentaLyte ® (6% HES, mean molecular weight 220 kDa) and Voluven ® (6% HES, 130 kDa). Methods: Rabbits were intravenously administered 20 ml/kg PentaLyte ® or Voluven ® ( n = 8 per fluid) over 10 min. Plasma was obtained prior to, 1 min and 1 h after hemodilution. Thrombelastography was performed, with clot initiation (R, sec), clot propagation (α, degrees), and clot strength (shear elastic modulus, G, dynes/cm 2 ) determined over 20 min. Celite‐activated samples had either no additions or addition of FI, FIIa or activated FXIII (FXIIIa) to restore protein content to pre‐diluted values. Results and conclusions: While there were no significant differences between the groups, R significantly decreased 1 h after hemodilution compared with values observed before and 1 min after hemodilution, whereas α and G significantly decreased 1 min after hemodilution and then significantly, but only partially, increased 1 h after hemodilution compared with pre‐dilution values. Addition of FI, FIIa and FXIIIa significantly decreased R in both groups. α and G 1 min after hemodilution were significantly enhanced by FI, FIIa, FXIIIa in both groups; however, 1 h after hemodilution, rabbits administered PentaLyte ® had α and G enhanced only by FI and FXIIIa addition, whereas animals administered Voluven ® had α and G significantly enhanced by FI addition. PentaLyte ® and Voluven ® hemodilution initially diminishes FIIa‐FI and FXIIIa‐fibrin, but within an hour primarily inhibit FXIIIa‐fibrin interactions in the rabbit.