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[Rotational thromboelastometry assessment of ballanced crystalloid, hydroxyethyl starch and gelatin effects on coagulation: a randomized trial].
Rev Bras Anestesiol. 2019 Jul - Aug; 69(4):383-389.RB

Abstract

BACKGROUND AND OBJECTIVES

Modern crystalloid and colloid solutions are balanced solutions which are increasingly used in perioperative period. However, studies investigating their negative effect on whole blood coagulation are missing, and vivid debate is going on about which solution has the minimal coagulopathy effect. The aim of our study was to assess the effect of modern fluid solutions on whole blood coagulation using rotational thromboelastometry.

METHODS

Blood samples were obtained from 30 patients during knee arthroscopy before and after administration of 500mL of crystalloid, Hydroxyethyl Starch and gelatin according to the randomization. Rotational thromboelastometry (Extem, Intem and Fibtem tests) was used to assess negative effect of fluid solutions on whole blood coagulation.

RESULTS

In Extem test, the initiation phase of fibrin clot formation represented by CT parameter was not influenced by any fluid solution (p>0.05). The speed of clot formation represented by CFT and α angle was impaired by Hydroxyethyl Starch and gelatin but not by crystalloids (p<0.05). The strength of formatted coagulum represented by MCF parameter was impaired both in Extem and Fibtem test by HES and in Fibtem also by crystalloids (p<0.05). Intem test was not negatively influenced by any crystalloid or colloid solution in any parameter (p>0.05).

CONCLUSION

Extem test appears to be sensitive to coagulopathy effect of modern colloids and crystalloids. Hydroxyethyl starch has the most obvious negative effect on clot formation followed by gelatin and finally by crystalloids. Intem test seems to be insensitive to adverse effect of modern colloids and crystalloids.

Authors+Show Affiliations

Charles University and Motol University Hospital, Second Faculty of Medicine, Department of Anaesthesiology and Intensive Care Medicine, Praga, Republica Tcheca.Charles University and Motol University Hospital, Second Faculty of Medicine, Department of Anaesthesiology and Intensive Care Medicine, Praga, Republica Tcheca. Electronic address: miroslav.durila@fnmotol.cz.Charles University and Motol University Hospital, Second Faculty of Medicine, Department of Anaesthesiology and Intensive Care Medicine, Praga, Republica Tcheca.

Pub Type(s)

English Abstract
Journal Article

Language

por

PubMed ID

31405567

Citation

Sevcikova, Silvie, et al. "[Rotational Thromboelastometry Assessment of Ballanced Crystalloid, Hydroxyethyl Starch and Gelatin Effects On Coagulation: a Randomized Trial]." Revista Brasileira De Anestesiologia, vol. 69, no. 4, 2019, pp. 383-389.
Sevcikova S, Durila M, Vymazal T. [Rotational thromboelastometry assessment of ballanced crystalloid, hydroxyethyl starch and gelatin effects on coagulation: a randomized trial]. Rev Bras Anestesiol. 2019;69(4):383-389.
Sevcikova, S., Durila, M., & Vymazal, T. (2019). [Rotational thromboelastometry assessment of ballanced crystalloid, hydroxyethyl starch and gelatin effects on coagulation: a randomized trial]. Revista Brasileira De Anestesiologia, 69(4), 383-389. https://doi.org/10.1016/j.bjan.2019.03.009
Sevcikova S, Durila M, Vymazal T. [Rotational Thromboelastometry Assessment of Ballanced Crystalloid, Hydroxyethyl Starch and Gelatin Effects On Coagulation: a Randomized Trial]. Rev Bras Anestesiol. 2019;69(4):383-389. PubMed PMID: 31405567.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Rotational thromboelastometry assessment of ballanced crystalloid, hydroxyethyl starch and gelatin effects on coagulation: a randomized trial]. AU - Sevcikova,Silvie, AU - Durila,Miroslav, AU - Vymazal,Tomas, Y1 - 2019/08/09/ PY - 2018/10/19/received PY - 2019/03/04/revised PY - 2019/03/17/accepted PY - 2019/8/14/pubmed PY - 2019/8/14/medline PY - 2019/8/14/entrez KW - Arthroscopy KW - Artroscopia KW - Coagulopathy KW - Coagulopatia KW - Cristaloides KW - Crystalloids KW - Gelatin KW - Gelatina KW - Hidroxietilamido KW - Hydroxyethyl starch KW - Rotational thromboelastometry KW - Tromboelastometria rotacional SP - 383 EP - 389 JF - Revista brasileira de anestesiologia JO - Rev Bras Anestesiol VL - 69 IS - 4 N2 - BACKGROUND AND OBJECTIVES: Modern crystalloid and colloid solutions are balanced solutions which are increasingly used in perioperative period. However, studies investigating their negative effect on whole blood coagulation are missing, and vivid debate is going on about which solution has the minimal coagulopathy effect. The aim of our study was to assess the effect of modern fluid solutions on whole blood coagulation using rotational thromboelastometry. METHODS: Blood samples were obtained from 30 patients during knee arthroscopy before and after administration of 500mL of crystalloid, Hydroxyethyl Starch and gelatin according to the randomization. Rotational thromboelastometry (Extem, Intem and Fibtem tests) was used to assess negative effect of fluid solutions on whole blood coagulation. RESULTS: In Extem test, the initiation phase of fibrin clot formation represented by CT parameter was not influenced by any fluid solution (p>0.05). The speed of clot formation represented by CFT and α angle was impaired by Hydroxyethyl Starch and gelatin but not by crystalloids (p<0.05). The strength of formatted coagulum represented by MCF parameter was impaired both in Extem and Fibtem test by HES and in Fibtem also by crystalloids (p<0.05). Intem test was not negatively influenced by any crystalloid or colloid solution in any parameter (p>0.05). CONCLUSION: Extem test appears to be sensitive to coagulopathy effect of modern colloids and crystalloids. Hydroxyethyl starch has the most obvious negative effect on clot formation followed by gelatin and finally by crystalloids. Intem test seems to be insensitive to adverse effect of modern colloids and crystalloids. SN - 1806-907X UR - https://www.unboundmedicine.com/medline/citation/31405567/[Rotational_thromboelastometry_assessment_of_ballanced_crystalloid_hydroxyethyl_starch_and_gelatin_effects_on_coagulation:_a_randomized_trial]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0034-7094(18)30479-3 DB - PRIME DP - Unbound Medicine ER -
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