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Comparison of the in vitro effects of saline, hypertonic hydroxyethyl starch, hypertonic saline, and two forms of hydroxyethyl starch on whole blood coagulation and platelet function in dogs.
J Vet Emerg Crit Care (San Antonio). 2015 Jul-Aug; 25(4):474-87.JV

Abstract

OBJECTIVE

To compare the in vitro effects of hypertonic solutions and colloids to saline on coagulation in dogs.

DESIGN

In vitro experimental study.

SETTING

Veterinary teaching hospital.

ANIMALS

Twenty-one adult dogs.

INTERVENTIONS

Blood samples were diluted with saline, 7.2% hypertonic saline solution with 6% hydroxyethylstarch with an average molecular weight of 200 kDa and a molar substitution of 0.4 (HH), 7.2% hypertonic saline (HTS), hydroxyethyl starch (HES) 130/0.4 or hydroxyethyl starch 600/0.75 at ratios of 1:22 and 1:9, and with saline and HES at a ratio of 1:3.

MEASUREMENTS AND MAIN RESULTS

Whole blood coagulation was analyzed using rotational thromboelastometry (extrinsic thromboelastometry-cloting time (ExTEM-CT), maximal clot firmness (MCF) and clot formation time (CFT) and fibrinogen function TEM-CT (FibTEM-CT) and MCF) and platelet function was analyzed using a platelet function analyzer (closure time, CTPFA). All parameters measured were impaired by saline dilution. The CTPFA was prolonged by 7.2% hypertonic saline solution with 6% hydroxyethylstarch with an average molecular weight of 200 kDa and a molar substitution of 0.4 (HH) and HTS but not by HES solutions. At clinical dilutions equivalent to those generally administered for shock (saline 1:3, HES 1:9, and hypertonic solutions 1:22), CTPFA was more prolonged by HH and HTS than other solutions but more by saline than HES. No difference was found between the HES solutions or the hypertonic solutions. ExTEM-CFT and MCF were impaired by HH and HTS but only mildly by HES solutions. At clinically relevant dilutions, no difference was found in ExTEM-CFT between HTS and saline or in ExTEM-MCF between HH and saline. No consistent difference was found between the 2 HES solutions but HH impaired ExTEM-CFT and MCF more than HTS. At high dilutions, FibTEM-CT and -MCF and ExTEM-CT were impaired by HES.

CONCLUSIONS

Hypertonic solutions affect platelet function and whole blood coagulation to a greater extent than saline and HES. At clinically relevant dilutions, only CTPFA was markedly more affected by hypertonic solutions than by saline. At high dilutions, HES significantly affects coagulation but to no greater extent than saline at clinically relevant dilutions.

Authors+Show Affiliations

Division of Small Animal Emergency and Critical Care, Department of Veterinary Clinical Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.the Diagnostic Laboratory, Department of Veterinary Clinical Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.Small Animal Internal Medicine, Department of Veterinary Clinical Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.Small Animal Internal Medicine, Department of Veterinary Clinical Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.Division of Small Animal Emergency and Critical Care, Department of Veterinary Clinical Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

26037241

Citation

Wurlod, Virginie A., et al. "Comparison of the in Vitro Effects of Saline, Hypertonic Hydroxyethyl Starch, Hypertonic Saline, and Two Forms of Hydroxyethyl Starch On Whole Blood Coagulation and Platelet Function in Dogs." Journal of Veterinary Emergency and Critical Care (San Antonio, Tex. : 2001), vol. 25, no. 4, 2015, pp. 474-87.
Wurlod VA, Howard J, Francey T, et al. Comparison of the in vitro effects of saline, hypertonic hydroxyethyl starch, hypertonic saline, and two forms of hydroxyethyl starch on whole blood coagulation and platelet function in dogs. J Vet Emerg Crit Care (San Antonio). 2015;25(4):474-87.
Wurlod, V. A., Howard, J., Francey, T., Schweighauser, A., & Adamik, K. N. (2015). Comparison of the in vitro effects of saline, hypertonic hydroxyethyl starch, hypertonic saline, and two forms of hydroxyethyl starch on whole blood coagulation and platelet function in dogs. Journal of Veterinary Emergency and Critical Care (San Antonio, Tex. : 2001), 25(4), 474-87. https://doi.org/10.1111/vec.12320
Wurlod VA, et al. Comparison of the in Vitro Effects of Saline, Hypertonic Hydroxyethyl Starch, Hypertonic Saline, and Two Forms of Hydroxyethyl Starch On Whole Blood Coagulation and Platelet Function in Dogs. J Vet Emerg Crit Care (San Antonio). 2015;25(4):474-87. PubMed PMID: 26037241.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of the in vitro effects of saline, hypertonic hydroxyethyl starch, hypertonic saline, and two forms of hydroxyethyl starch on whole blood coagulation and platelet function in dogs. AU - Wurlod,Virginie A, AU - Howard,Judith, AU - Francey,Thierry, AU - Schweighauser,Ariane, AU - Adamik,Katja N, Y1 - 2015/06/02/ PY - 2013/06/26/received PY - 2013/11/22/accepted PY - 2015/6/4/entrez PY - 2015/6/4/pubmed PY - 2016/2/10/medline KW - ROTEM KW - canine KW - colloids KW - dilutional coagulopathy KW - platelet function analyzer KW - thromboelastometry SP - 474 EP - 87 JF - Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) JO - J Vet Emerg Crit Care (San Antonio) VL - 25 IS - 4 N2 - OBJECTIVE: To compare the in vitro effects of hypertonic solutions and colloids to saline on coagulation in dogs. DESIGN: In vitro experimental study. SETTING: Veterinary teaching hospital. ANIMALS: Twenty-one adult dogs. INTERVENTIONS: Blood samples were diluted with saline, 7.2% hypertonic saline solution with 6% hydroxyethylstarch with an average molecular weight of 200 kDa and a molar substitution of 0.4 (HH), 7.2% hypertonic saline (HTS), hydroxyethyl starch (HES) 130/0.4 or hydroxyethyl starch 600/0.75 at ratios of 1:22 and 1:9, and with saline and HES at a ratio of 1:3. MEASUREMENTS AND MAIN RESULTS: Whole blood coagulation was analyzed using rotational thromboelastometry (extrinsic thromboelastometry-cloting time (ExTEM-CT), maximal clot firmness (MCF) and clot formation time (CFT) and fibrinogen function TEM-CT (FibTEM-CT) and MCF) and platelet function was analyzed using a platelet function analyzer (closure time, CTPFA). All parameters measured were impaired by saline dilution. The CTPFA was prolonged by 7.2% hypertonic saline solution with 6% hydroxyethylstarch with an average molecular weight of 200 kDa and a molar substitution of 0.4 (HH) and HTS but not by HES solutions. At clinical dilutions equivalent to those generally administered for shock (saline 1:3, HES 1:9, and hypertonic solutions 1:22), CTPFA was more prolonged by HH and HTS than other solutions but more by saline than HES. No difference was found between the HES solutions or the hypertonic solutions. ExTEM-CFT and MCF were impaired by HH and HTS but only mildly by HES solutions. At clinically relevant dilutions, no difference was found in ExTEM-CFT between HTS and saline or in ExTEM-MCF between HH and saline. No consistent difference was found between the 2 HES solutions but HH impaired ExTEM-CFT and MCF more than HTS. At high dilutions, FibTEM-CT and -MCF and ExTEM-CT were impaired by HES. CONCLUSIONS: Hypertonic solutions affect platelet function and whole blood coagulation to a greater extent than saline and HES. At clinically relevant dilutions, only CTPFA was markedly more affected by hypertonic solutions than by saline. At high dilutions, HES significantly affects coagulation but to no greater extent than saline at clinically relevant dilutions. SN - 1476-4431 UR - https://www.unboundmedicine.com/medline/citation/26037241/Comparison_of_the_in_vitro_effects_of_saline_hypertonic_hydroxyethyl_starch_hypertonic_saline_and_two_forms_of_hydroxyethyl_starch_on_whole_blood_coagulation_and_platelet_function_in_dogs_ L2 - https://doi.org/10.1111/vec.12320 DB - PRIME DP - Unbound Medicine ER -