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The effect of colloid and crystalloid preloading on thromboelastography prior to Cesarean delivery.
Can J Anaesth. 2007 Mar; 54(3):190-5.CJ

Abstract

PURPOSE

Fluid preloading with colloids reduces hypotension after spinal anesthesia for Cesarean delivery more effectively than crystalloids. However, the effects of fluid preloading regimens on coagulation in pregnant patients remain unresolved. The aim of this study was to compare the effects on coagulation of fluid preloading with 6% hydroxyethyl starch (HES) and lactated Ringer's (LR) solution using thromboelastography (TEG) with kaolin-activated whole blood in healthy pregnant patients prior to spinal anesthesia for Cesarean delivery.

METHODS

After obtaining Ethics committee approval, 30 parturients were prospectively randomized prior to spinal anesthesia for elective Cesarean delivery to receive fluid preloading with either 1500 mL LR or 500 mL 6% HES over 30 min. Thromboelastography was performed immediately prior to and after fluid preloading. Standard TEG parameters were analyzed in terms of r time (min), k time (min), alpha angle (degrees) and maximum amplitude (mm).

RESULTS

Group HES had statistically significant longer reaction times (r) and clot formation times (k) after fluid loading compared to baseline values (P < 0.05 respectively), although these post-fluid loading TEG parameters remained within a normal reference range. No significant differences in TEG values were seen after preloading within the LR group.

CONCLUSION

Fluid preloading with 500 mL 6% HES in healthy parturients produced mild coagulation effects, as measured with TEG, prior to spinal anesthesia for Cesarean delivery. No significant effects on coagulation with TEG were observed following preloading with 1500 mL LR.

Authors+Show Affiliations

Department of Anesthesia, H3580, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, California 94305, USA.No affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

17331930

Citation

Butwick, Alexander, and Brendan Carvalho. "The Effect of Colloid and Crystalloid Preloading On Thromboelastography Prior to Cesarean Delivery." Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, vol. 54, no. 3, 2007, pp. 190-5.
Butwick A, Carvalho B. The effect of colloid and crystalloid preloading on thromboelastography prior to Cesarean delivery. Can J Anaesth. 2007;54(3):190-5.
Butwick, A., & Carvalho, B. (2007). The effect of colloid and crystalloid preloading on thromboelastography prior to Cesarean delivery. Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, 54(3), 190-5.
Butwick A, Carvalho B. The Effect of Colloid and Crystalloid Preloading On Thromboelastography Prior to Cesarean Delivery. Can J Anaesth. 2007;54(3):190-5. PubMed PMID: 17331930.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of colloid and crystalloid preloading on thromboelastography prior to Cesarean delivery. AU - Butwick,Alexander, AU - Carvalho,Brendan, PY - 2007/3/3/pubmed PY - 2007/6/26/medline PY - 2007/3/3/entrez SP - 190 EP - 5 JF - Canadian journal of anaesthesia = Journal canadien d'anesthesie JO - Can J Anaesth VL - 54 IS - 3 N2 - PURPOSE: Fluid preloading with colloids reduces hypotension after spinal anesthesia for Cesarean delivery more effectively than crystalloids. However, the effects of fluid preloading regimens on coagulation in pregnant patients remain unresolved. The aim of this study was to compare the effects on coagulation of fluid preloading with 6% hydroxyethyl starch (HES) and lactated Ringer's (LR) solution using thromboelastography (TEG) with kaolin-activated whole blood in healthy pregnant patients prior to spinal anesthesia for Cesarean delivery. METHODS: After obtaining Ethics committee approval, 30 parturients were prospectively randomized prior to spinal anesthesia for elective Cesarean delivery to receive fluid preloading with either 1500 mL LR or 500 mL 6% HES over 30 min. Thromboelastography was performed immediately prior to and after fluid preloading. Standard TEG parameters were analyzed in terms of r time (min), k time (min), alpha angle (degrees) and maximum amplitude (mm). RESULTS: Group HES had statistically significant longer reaction times (r) and clot formation times (k) after fluid loading compared to baseline values (P < 0.05 respectively), although these post-fluid loading TEG parameters remained within a normal reference range. No significant differences in TEG values were seen after preloading within the LR group. CONCLUSION: Fluid preloading with 500 mL 6% HES in healthy parturients produced mild coagulation effects, as measured with TEG, prior to spinal anesthesia for Cesarean delivery. No significant effects on coagulation with TEG were observed following preloading with 1500 mL LR. SN - 0832-610X UR - https://www.unboundmedicine.com/medline/citation/17331930/The_effect_of_colloid_and_crystalloid_preloading_on_thromboelastography_prior_to_Cesarean_delivery_ L2 - https://doi.org/10.1007/BF03022639 DB - PRIME DP - Unbound Medicine ER -