Hydroxyethyl starch impairs in vitro coagulation

• Published in: Acta anaesthesiologica Scandinavica 1998-10, Vol.42 (9), p.1104-1109
• Main Authors: Niemi, T. T., Kuitunen, A. H.
• Format: Article
• Language: English
• Subjects: Adult; albumin; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Coagulation - drug effects; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Cross-Over Studies; Hemodilution; Hemostasis - drug effects; Humans; Hydroxyethyl starch; Hydroxyethyl Starch Derivatives - adverse effects; in vitro hemotasis; Male; Medical sciences; Plasma Substitutes - adverse effects; thrombelastography; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
• ISSN: 0001-5172; 1399-6576
• DOI: 10.1111/j.1399-6576.1998.tb05385.x

Background: Artificial colloids affect haemostasis. Particularly hydroxyethyl starch (HES) solutions may have detrimental effects on haemostatic mechanisms. Methods: In a crossover study blood was withdrawn from ten volunteers. Ringer's acetate, 6% low molecular weight HES (Mw 120 000/molar substitution ratio 0.7), 10% low molecular weight HES Mw 200 000/0.5) and 6% high molecular weight HES (Mw 400 000/0.7) or 4% albumin was added to venous blood samples to make either 20 vol.% or 50 vol.% concentrations of each of the solutions. Samples were analyzed by thrombelastography (TEG). Results: All HES solutions at 20 vol.% concentration impaired haemostasis as demonstrated by decreased clot formation rate (α‐angle and maximum amplitude (MA)). In contrast, Ringer's acetate and albumin improved coagulability at 20 vol.% concentrations. Coagulation time (r+K) was prolonged at 50 vol.% dilutions of all solutions. The median r+K was greater with HES 400 (P