Tags

Type your tag names separated by a space and hit enter

Effect of the carrier solution for hydroxyethyl starch on platelet aggregation and clot formation.
Br J Anaesth. 2012 Oct; 109(4):572-7.BJ

Abstract

BACKGROUND

Hydroxyethyl starch (HES) solutions alter blood coagulation, mainly platelet function and fibrinogen polymerization. Haemostasis can also be impaired by dilutional-hyperchloraemic acidosis induced by the HES carrier solution. We hypothesized that a saline-based tetrastarch carrier solution impairs parameters of blood coagulation more than a balanced carrier solution.

METHODS

The study was designed as a prospective, double-blinded, randomized, cross-over trial in healthy male volunteers. At intervals of at least 10 days, 13 subjects received 20 ml kg(-1) of balanced or saline-based tetrastarch over 2 h. Blood was subjected to blood gas analysis, assessment of platelet function [with multiple electrode aggregometry (MEA)], and clot formation (with rotational thrombelastometry).

RESULTS

Maximum aggregation in response to adenosine diphosphate (ADP) decreased after saline-based HES infusion, but not after balanced solution-based HES infusion. ADP-induced platelet aggregation was significantly lower after saline-based HES compared with baseline (21%; P<0.025) and compared with balanced solution-based HES (17%; P<0.025). There were no significant changes in platelet aggregation induced by thrombin receptor-activating peptide and in any parameter of rotational thrombelastometry. Chloride concentrations were significantly higher after saline-based HES compared with balanced solution-based HES.

CONCLUSIONS

The carrier solution for HES up to 20 ml kg(-1) had little impact on platelet aggregation or clot formation as assessed by MEA and rotational thrombelastometry, respectively. Further clinical studies are required to verify this finding in patients and to correlate results of whole blood aggregometry and rotational thrombelastometry with perioperative bleeding and transfusion requirements.

Authors+Show Affiliations

Department of Anaesthesia, General Intensive Care and Pain Control, Medical University of Vienna, Vienna, Austria.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

22791802

Citation

Schaden, E, et al. "Effect of the Carrier Solution for Hydroxyethyl Starch On Platelet Aggregation and Clot Formation." British Journal of Anaesthesia, vol. 109, no. 4, 2012, pp. 572-7.
Schaden E, Wetzel L, Kozek-Langenecker S, et al. Effect of the carrier solution for hydroxyethyl starch on platelet aggregation and clot formation. Br J Anaesth. 2012;109(4):572-7.
Schaden, E., Wetzel, L., Kozek-Langenecker, S., Thaler, U., & Scharbert, G. (2012). Effect of the carrier solution for hydroxyethyl starch on platelet aggregation and clot formation. British Journal of Anaesthesia, 109(4), 572-7. https://doi.org/10.1093/bja/aes229
Schaden E, et al. Effect of the Carrier Solution for Hydroxyethyl Starch On Platelet Aggregation and Clot Formation. Br J Anaesth. 2012;109(4):572-7. PubMed PMID: 22791802.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of the carrier solution for hydroxyethyl starch on platelet aggregation and clot formation. AU - Schaden,E, AU - Wetzel,L, AU - Kozek-Langenecker,S, AU - Thaler,U, AU - Scharbert,G, Y1 - 2012/07/11/ PY - 2012/7/14/entrez PY - 2012/7/14/pubmed PY - 2012/12/10/medline SP - 572 EP - 7 JF - British journal of anaesthesia JO - Br J Anaesth VL - 109 IS - 4 N2 - BACKGROUND: Hydroxyethyl starch (HES) solutions alter blood coagulation, mainly platelet function and fibrinogen polymerization. Haemostasis can also be impaired by dilutional-hyperchloraemic acidosis induced by the HES carrier solution. We hypothesized that a saline-based tetrastarch carrier solution impairs parameters of blood coagulation more than a balanced carrier solution. METHODS: The study was designed as a prospective, double-blinded, randomized, cross-over trial in healthy male volunteers. At intervals of at least 10 days, 13 subjects received 20 ml kg(-1) of balanced or saline-based tetrastarch over 2 h. Blood was subjected to blood gas analysis, assessment of platelet function [with multiple electrode aggregometry (MEA)], and clot formation (with rotational thrombelastometry). RESULTS: Maximum aggregation in response to adenosine diphosphate (ADP) decreased after saline-based HES infusion, but not after balanced solution-based HES infusion. ADP-induced platelet aggregation was significantly lower after saline-based HES compared with baseline (21%; P<0.025) and compared with balanced solution-based HES (17%; P<0.025). There were no significant changes in platelet aggregation induced by thrombin receptor-activating peptide and in any parameter of rotational thrombelastometry. Chloride concentrations were significantly higher after saline-based HES compared with balanced solution-based HES. CONCLUSIONS: The carrier solution for HES up to 20 ml kg(-1) had little impact on platelet aggregation or clot formation as assessed by MEA and rotational thrombelastometry, respectively. Further clinical studies are required to verify this finding in patients and to correlate results of whole blood aggregometry and rotational thrombelastometry with perioperative bleeding and transfusion requirements. SN - 1471-6771 UR - https://www.unboundmedicine.com/medline/citation/22791802/Effect_of_the_carrier_solution_for_hydroxyethyl_starch_on_platelet_aggregation_and_clot_formation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0007-0912(17)32063-9 DB - PRIME DP - Unbound Medicine ER -