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In vitro evaluation of canine hemostasis following dilution with hydroxyethyl starch (130/0.4) via thromboelastometry
Author(s) -
Falco Sara,
Bruno Barbara,
Maurella Cristiana,
Bellino Claudio,
D'Angelo Antonio,
Gianella Paola,
Tarducci Alberto,
Zanatta Renato,
Borrelli Antonio
Publication year - 2012
Publication title -
journal of veterinary emergency and critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.886
H-Index - 47
eISSN - 1476-4431
pISSN - 1479-3261
DOI - 10.1111/j.1476-4431.2012.00816.x
Subject(s) - hydroxyethyl starch , thromboelastometry , medicine , venipuncture , saline , serial dilution , dilution , hemostasis , anesthesia , whole blood , pathology , physics , alternative medicine , thermodynamics
Objective To assess the effects of in vitro hemodilution of canine blood with a low molecular weight hy‐droxyethyl starch ( HES 130/0.4) by means of thromboelastometry ( TEM ). Design In vitro experimental study. Setting University Teaching Hospital. Animals Ten healthy adult staff‐owned dogs were sampled for the purposes of the study. Samples were also collected from 45 clinically normal dogs to establish thromboelastometric reference intervals. Interventions For each dog whole blood was collected by jugular venipuncture and placed into tubes containing 3.8% trisodium citrate and stored at 37°C. Two standard dilutions (1:4 and 1:10) from canine blood specimens were prepared with HES 130/0.4 and saline 0.9%. Measurements and Main Results The effects of dilution were studied by TEM . No statistically significant differences were observed between the TEM values of the control samples and the samples diluted with saline solution (ratio 1:10 and 1:4). In contrast, hypocoagulability was observed in the samples treated with HES 130/0.4, with more severe effects at 1:4 dilution than at 1:10 dilution. The 1:4 dilution with HES 130/0.4 produced marked alterations: CT ( P = 0.035) and CFT ( P = 0.0007) on the ex‐TEM profile, CT ( P = 0.0005) and ML ( P = 0.0017) on the fib‐TEM profile and CFT ( P = 0.0043) on the in‐TEM, were all significantly increased ( P < 0.05), whereas MCF ( P = 0.0042) and alpha angle ( P = 0.002) on the in‐TEM and MCF ( P = 0.011) and alpha angle ( P = 0.001) ex‐TEM profiles and MCF ( P = 0.0001) on the fib‐TEM profile were significantly decreased ( P < 0.05). Conclusions Dilution of canine blood with HES 130/0.4 results in a thromboelastometric pattern consistent with hypocoagulation and this effect appears to result from a dose‐dependent alteration in fibrinogen concentration and inhibition of platelet function. As this is an in vitro study, further in vivo investigations are necessary to confirm the results.