Effects of Hextend Hemodilution on Plasma Coagulation Kinetics in the Rabbit: Role of Factor XIII-Mediated Fibrin Polymer Crosslinking

Fibrinogen and FXIII dose response effects on albumin-induced coagulopathy

“…Both colloids and crystalloids can cause coagulopathy by dilution of coagulation factors such as fibrinogen and platelets, resulting in a reduction in clot strength, while haemodilution with synthetic colloids causes coagulopathy through inhibitory effects on clotting factors [24][25][26], platelet function [27,28] and fibrin polymerisation [10,29].…”

Hemodilution Modulates the Time of Onset and Rate of Fibrinolysis in Human and Rabbit Plasma

“…Archived, citrated rabbit plasma samples stored at Ϫ85°C, obtained from previous in vivo hemodilution experiments, 10,11 were subjected to fibrinolytic stress and thrombelastographic analyses as described in what follows. This data set was not included in the aforementioned investigations, 10,11 because neither the thrombelastographic technology nor the specific hematologic paradigm had been formulated before submission.…”

“…This data set was not included in the aforementioned investigations, 10,11 because neither the thrombelastographic technology nor the specific hematologic paradigm had been formulated before submission. The hemodilution protocol is described subsequently.…”

“…Hemodynamic, arterial blood gas and thrombelastographic data (without fibrinolytic stress) have been described in detail elsewhere. 10,11 Animals administered these colloids had a 30% hemodilution based on a hematocrit level that persisted for 1 hour in the case of Hextend, 11 and decreased to 16% hemodilution in rabbits administered PentaLyte or Voluven. 10…”

“…9 In vivo hemodilution with HES (130 to 450 kD) also decreased FXIIIa-fibrin polymer interactions with consequent decreases in coagulation kinetics in rabbits. 10,11 FXIIIa increases clot strength by cross-linking glutamine and lysine residues of fibrin polymers, and also renders clots resistant to fibrinolysis by linking ␣ 2 -anti-plasmin to the fibrin matrix. 12 Considered as a whole, dilution with colloidal solutions may result in a clot vulnerable to fibrinolytic disintegration by first diminishing initial FXIIIa-mediated strength and, second, by attenuating ␣ 2 -anti-plasmin deposition on fibrin polymers, enhancing plasmin-mediated fibrin degradation.…”