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

Post‐operative volume therapy in cardiac surgery: effects on hemostatic and circulatory variables

“…Several studies have reported that both CPB and use of colloids per se may activate fibrinolysis (Nielsen 2006), and use of antifibrinolytic drugs has been considered (Sedrakyan et al 2006). The results of the present thesis do not support routine use of fibrinolysis inhibitors in patients undergoing elective cardiac surgery.…”

“…In studies assessing viscoelastic properties of whole blood, HES has been consistently demonstrated to disturb fibrin formation and to reduce clot firmness Kuitunen 1998, Boldt et al 2007). The resulting thrombus is therefore less stable and more susceptible to lysis (Nielsen 2006). After these findings it was not surprising that even slight coagulation disorders were considered as a contraindication for the use of hetastarches.…”

The effect of tranexamic acid on blood coagulation in total hip replacement arthroplasty: rotational thromboelastographic (ROTEM®) analysis

“…With regard to fibrinolysis, HES may exacerbate fibrinolysis because it reduces a 2 -antiplasmin-plasmin interactions [4], and haemodilution with HES may promote more rapid fibrinolysis [15]. In addition, significant regional fibrinolysis has been reported during femoral implantation [16], and postoperative fibrinolysis peaked at 6 h following surgery and was maintained for up to 18 h after THR [1].…”

Comparative Study Between Succinylated Gelatin (Gelofusine) Versus Ringer’s Acetate Regarding Safety and Efficacy in Adult Patients Undergoing Cardiac Surgery.

“…Also, there was a significant decrease in hemoglobin concentration and hematocrit in succinylated gelatin group. This is met with Schramko et al (38) and Nielsen VG (39) who reported that both gelatin and HES solutions decreased Hb, Hct, and PC more than Ringer's acetate. Also in their study about the effect of intravenous fluids (including; albumin, gelofusine, Haemaccel and saline) on platelet function and hemostasis in elective hip surgery, Evans et al (40) reported that there was a significant decrease of Hb, Hct and platelet count when comparing pre and post and pre and last time points in all fluid groups with less fall in saline group.…”