Effect of hydroxyethyl starch on coagulopathy in a swine model of hemorrhagic shock resuscitation

Darin Via, Christoph Kaufmann, Dan Anderson, Kathy Stanton, Peter M Rhee

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Hydroxyethyl starch (HES) has a known dose-dependant effect on coagulopathy. The purpose of this study was to determine the effect of HES on coagulopathy after a period of hemorrhagic shock. Methods: Anesthetized swine underwent a 15-minute, 40% blood volume hemorrhage (28 mL/kg) and a 1-hour shock period, followed by resuscitation with sham resuscitation (group I); 6% HES, 15 mL/kg (group II); 5% albumin, 15 mL/kg (group III); lactated Ringer's solution, 39 mL/kg, and 6% HES, 15 mL/kg (group IV); and lactated Ringer's solution, 39 mL/kg, and 5% albumin, 15 mL/kg (group V). Coagulation function was measured by bleeding time, prothrombin time, partial thromboplastin time, fibrinogen, platelet count, and thromboelastography. Results: Platelet counts decreased significantly (p < 0.05) in all resuscitation groups except the sham resuscitation group. A significant decrease in platelets, fibrinogen levels, and maximum amplitude on thromboelastography was related to a dilutional effect of the fluid given and not a result of HES at the dose tested. Conclusion: The linear dose-related coagulopathic effects of HES when given at moderate doses does not seem to be worsened by prolonged periods of hemorrhagic shock. The coagulopathy seen during resuscitation from hemorrhagic shock seems to be a dilutional effect.

Original languageEnglish (US)
Pages (from-to)1076-1082
Number of pages7
JournalJournal of Trauma
Volume50
Issue number6
StatePublished - 2001
Externally publishedYes

Fingerprint

Hemorrhagic Shock
Resuscitation
Starch
Swine
Thrombelastography
Platelet Count
Fibrinogen
Albumins
Bleeding Time
Partial Thromboplastin Time
Prothrombin Time
Blood Volume
Shock
Blood Platelets
Hemorrhage

Keywords

  • Albumin
  • Coagulation
  • Hemorrhage
  • Hydroxyethyl starch
  • Lactated Ringer's solution
  • Resuscitation
  • Shock
  • Thrombelastography

ASJC Scopus subject areas

  • Surgery

Cite this

Effect of hydroxyethyl starch on coagulopathy in a swine model of hemorrhagic shock resuscitation. / Via, Darin; Kaufmann, Christoph; Anderson, Dan; Stanton, Kathy; Rhee, Peter M.

In: Journal of Trauma, Vol. 50, No. 6, 2001, p. 1076-1082.

Research output: Contribution to journalArticle

Via, D, Kaufmann, C, Anderson, D, Stanton, K & Rhee, PM 2001, 'Effect of hydroxyethyl starch on coagulopathy in a swine model of hemorrhagic shock resuscitation', Journal of Trauma, vol. 50, no. 6, pp. 1076-1082.
Via, Darin ; Kaufmann, Christoph ; Anderson, Dan ; Stanton, Kathy ; Rhee, Peter M. / Effect of hydroxyethyl starch on coagulopathy in a swine model of hemorrhagic shock resuscitation. In: Journal of Trauma. 2001 ; Vol. 50, No. 6. pp. 1076-1082.
@article{1a3f8afb3a8d4846b9d55bd6defbd5f2,
title = "Effect of hydroxyethyl starch on coagulopathy in a swine model of hemorrhagic shock resuscitation",
abstract = "Background: Hydroxyethyl starch (HES) has a known dose-dependant effect on coagulopathy. The purpose of this study was to determine the effect of HES on coagulopathy after a period of hemorrhagic shock. Methods: Anesthetized swine underwent a 15-minute, 40{\%} blood volume hemorrhage (28 mL/kg) and a 1-hour shock period, followed by resuscitation with sham resuscitation (group I); 6{\%} HES, 15 mL/kg (group II); 5{\%} albumin, 15 mL/kg (group III); lactated Ringer's solution, 39 mL/kg, and 6{\%} HES, 15 mL/kg (group IV); and lactated Ringer's solution, 39 mL/kg, and 5{\%} albumin, 15 mL/kg (group V). Coagulation function was measured by bleeding time, prothrombin time, partial thromboplastin time, fibrinogen, platelet count, and thromboelastography. Results: Platelet counts decreased significantly (p < 0.05) in all resuscitation groups except the sham resuscitation group. A significant decrease in platelets, fibrinogen levels, and maximum amplitude on thromboelastography was related to a dilutional effect of the fluid given and not a result of HES at the dose tested. Conclusion: The linear dose-related coagulopathic effects of HES when given at moderate doses does not seem to be worsened by prolonged periods of hemorrhagic shock. The coagulopathy seen during resuscitation from hemorrhagic shock seems to be a dilutional effect.",
keywords = "Albumin, Coagulation, Hemorrhage, Hydroxyethyl starch, Lactated Ringer's solution, Resuscitation, Shock, Thrombelastography",
author = "Darin Via and Christoph Kaufmann and Dan Anderson and Kathy Stanton and Rhee, {Peter M}",
year = "2001",
language = "English (US)",
volume = "50",
pages = "1076--1082",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Effect of hydroxyethyl starch on coagulopathy in a swine model of hemorrhagic shock resuscitation

AU - Via, Darin

AU - Kaufmann, Christoph

AU - Anderson, Dan

AU - Stanton, Kathy

AU - Rhee, Peter M

PY - 2001

Y1 - 2001

N2 - Background: Hydroxyethyl starch (HES) has a known dose-dependant effect on coagulopathy. The purpose of this study was to determine the effect of HES on coagulopathy after a period of hemorrhagic shock. Methods: Anesthetized swine underwent a 15-minute, 40% blood volume hemorrhage (28 mL/kg) and a 1-hour shock period, followed by resuscitation with sham resuscitation (group I); 6% HES, 15 mL/kg (group II); 5% albumin, 15 mL/kg (group III); lactated Ringer's solution, 39 mL/kg, and 6% HES, 15 mL/kg (group IV); and lactated Ringer's solution, 39 mL/kg, and 5% albumin, 15 mL/kg (group V). Coagulation function was measured by bleeding time, prothrombin time, partial thromboplastin time, fibrinogen, platelet count, and thromboelastography. Results: Platelet counts decreased significantly (p < 0.05) in all resuscitation groups except the sham resuscitation group. A significant decrease in platelets, fibrinogen levels, and maximum amplitude on thromboelastography was related to a dilutional effect of the fluid given and not a result of HES at the dose tested. Conclusion: The linear dose-related coagulopathic effects of HES when given at moderate doses does not seem to be worsened by prolonged periods of hemorrhagic shock. The coagulopathy seen during resuscitation from hemorrhagic shock seems to be a dilutional effect.

AB - Background: Hydroxyethyl starch (HES) has a known dose-dependant effect on coagulopathy. The purpose of this study was to determine the effect of HES on coagulopathy after a period of hemorrhagic shock. Methods: Anesthetized swine underwent a 15-minute, 40% blood volume hemorrhage (28 mL/kg) and a 1-hour shock period, followed by resuscitation with sham resuscitation (group I); 6% HES, 15 mL/kg (group II); 5% albumin, 15 mL/kg (group III); lactated Ringer's solution, 39 mL/kg, and 6% HES, 15 mL/kg (group IV); and lactated Ringer's solution, 39 mL/kg, and 5% albumin, 15 mL/kg (group V). Coagulation function was measured by bleeding time, prothrombin time, partial thromboplastin time, fibrinogen, platelet count, and thromboelastography. Results: Platelet counts decreased significantly (p < 0.05) in all resuscitation groups except the sham resuscitation group. A significant decrease in platelets, fibrinogen levels, and maximum amplitude on thromboelastography was related to a dilutional effect of the fluid given and not a result of HES at the dose tested. Conclusion: The linear dose-related coagulopathic effects of HES when given at moderate doses does not seem to be worsened by prolonged periods of hemorrhagic shock. The coagulopathy seen during resuscitation from hemorrhagic shock seems to be a dilutional effect.

KW - Albumin

KW - Coagulation

KW - Hemorrhage

KW - Hydroxyethyl starch

KW - Lactated Ringer's solution

KW - Resuscitation

KW - Shock

KW - Thrombelastography

UR - http://www.scopus.com/inward/record.url?scp=0034950831&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034950831&partnerID=8YFLogxK

M3 - Article

VL - 50

SP - 1076

EP - 1082

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 6

ER -