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Colloids decrease clot propagation and strength: role of factor XIII-fibrin polymer and thrombin-fibrinogen interactions.
Acta Anaesthesiol Scand. 2005 Sep; 49(8):1163-71.AA

Abstract

Colloid-mediated hypocoagulability is clinically important, but the mechanisms responsible for coagulopathy have been incompletely defined. Thus, my goal was to elucidate how colloids decrease plasma coagulation function. Plasma was diluted 0% or 40% with 0.9% NaCl, three different hydroxyethyl starches (HES, mean molecular weight 450, 220 or 130 kDa), or 5% human albumin. Samples (n=6 per condition) were activated with celite, and diluted samples had either no additions or addition of fibrinogen (FI), thrombin (FIIa) or activated Factor XIII (FXIIIa) to restore protein function to prediluted values. Thrombelastographic variables measured included clot propagation (angle, alpha), and clot strength (amplitude, A; or shear elastic modulus, G). Dilution with 0.9% NaCl significantly decreased alpha, A and G-values compared to undiluted samples. Supplementation with FI, but not FIIa or FXIIIa, resulted in 0.9% NaCl-diluted thrombelastographic variable values not different from those of undiluted samples. FI supplementation of HES 450, HES 220, HES 130 and albumin-diluted samples only partially restored alpha, A and G-values compared to undiluted samples. FIIa addition only improved clot propagation and strength in albumin-diluted samples. FXIIIa supplementation improved propagation in samples diluted with HES 450, HES 220 and albumin, and clot strength improved in HES 450 and albumin-diluted plasma. Considered as a whole, these data support compromise of FIIa-FI and FXIIIa--fibrin polymer interactions as the mechanisms by which colloids compromise plasma coagulation. Investigation to determine if clinical enhancement of FXIII activity and/or FI concentration (e.g. fresh-frozen plasma, cryoprecipitate) can attenuate colloid-mediated decreases in hemostasis is warranted.

Authors+Show Affiliations

Department of Anesthesiology, The University of Alabama at Birmingham, Birmingham, AL 35249-6810, USA. vnielsen@uab.edu

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16095459

Citation

Nielsen, V G.. "Colloids Decrease Clot Propagation and Strength: Role of Factor XIII-fibrin Polymer and Thrombin-fibrinogen Interactions." Acta Anaesthesiologica Scandinavica, vol. 49, no. 8, 2005, pp. 1163-71.
Nielsen VG. Colloids decrease clot propagation and strength: role of factor XIII-fibrin polymer and thrombin-fibrinogen interactions. Acta Anaesthesiol Scand. 2005;49(8):1163-71.
Nielsen, V. G. (2005). Colloids decrease clot propagation and strength: role of factor XIII-fibrin polymer and thrombin-fibrinogen interactions. Acta Anaesthesiologica Scandinavica, 49(8), 1163-71.
Nielsen VG. Colloids Decrease Clot Propagation and Strength: Role of Factor XIII-fibrin Polymer and Thrombin-fibrinogen Interactions. Acta Anaesthesiol Scand. 2005;49(8):1163-71. PubMed PMID: 16095459.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Colloids decrease clot propagation and strength: role of factor XIII-fibrin polymer and thrombin-fibrinogen interactions. A1 - Nielsen,V G, PY - 2005/8/13/pubmed PY - 2005/11/9/medline PY - 2005/8/13/entrez SP - 1163 EP - 71 JF - Acta anaesthesiologica Scandinavica JO - Acta Anaesthesiol Scand VL - 49 IS - 8 N2 - Colloid-mediated hypocoagulability is clinically important, but the mechanisms responsible for coagulopathy have been incompletely defined. Thus, my goal was to elucidate how colloids decrease plasma coagulation function. Plasma was diluted 0% or 40% with 0.9% NaCl, three different hydroxyethyl starches (HES, mean molecular weight 450, 220 or 130 kDa), or 5% human albumin. Samples (n=6 per condition) were activated with celite, and diluted samples had either no additions or addition of fibrinogen (FI), thrombin (FIIa) or activated Factor XIII (FXIIIa) to restore protein function to prediluted values. Thrombelastographic variables measured included clot propagation (angle, alpha), and clot strength (amplitude, A; or shear elastic modulus, G). Dilution with 0.9% NaCl significantly decreased alpha, A and G-values compared to undiluted samples. Supplementation with FI, but not FIIa or FXIIIa, resulted in 0.9% NaCl-diluted thrombelastographic variable values not different from those of undiluted samples. FI supplementation of HES 450, HES 220, HES 130 and albumin-diluted samples only partially restored alpha, A and G-values compared to undiluted samples. FIIa addition only improved clot propagation and strength in albumin-diluted samples. FXIIIa supplementation improved propagation in samples diluted with HES 450, HES 220 and albumin, and clot strength improved in HES 450 and albumin-diluted plasma. Considered as a whole, these data support compromise of FIIa-FI and FXIIIa--fibrin polymer interactions as the mechanisms by which colloids compromise plasma coagulation. Investigation to determine if clinical enhancement of FXIII activity and/or FI concentration (e.g. fresh-frozen plasma, cryoprecipitate) can attenuate colloid-mediated decreases in hemostasis is warranted. SN - 0001-5172 UR - https://www.unboundmedicine.com/medline/citation/16095459/Colloids_decrease_clot_propagation_and_strength:_role_of_factor_XIII_fibrin_polymer_and_thrombin_fibrinogen_interactions_ L2 - https://doi.org/10.1111/j.1399-6576.2005.00733.x DB - PRIME DP - Unbound Medicine ER -