In vitro evaluation of canine hemostasis following dilution with hydroxyethyl starch (130/0.4) via thromboelastometry

Abstract

Dilution of canine blood with HES 130/0.4 results in a thromboelastometric pattern consistent with hypocoagulation and this effect appears to result from a dose-dependent alteration in fibrinogen concentration and inhibition of platelet function. As this is an in vitro study, further in vivo investigations are necessary to confirm the results.

Assessment of coagulation utilizing thromboelastometry in dogs undergoing orthopedic surgery

“…The MCF was increased in the fib‐TEM profile at T2 compared with T1. Despite these significant changes, all results were within our institutional reference intervals (Table ) …”

Platelet closure time in anesthetized Greyhounds with hemorrhagic shock treated with hydroxyethyl starch 130/0.4 or 0.9% sodium chloride infusions

“…The failure to cause a significant change in PCT with HES 130/0.4, beyond hemodilution, may also be explained by the use of a 20 mL/kg dose. A 1:4 dilution of HES 130/0.4 with canine whole blood caused greater abnormalities in coagulation, as measured by thromboelastometry, compared with a 1:10 dilution, which suggests a dose‐dependent effect on coagulation . This study did not assess platelet function specifically.…”

The effect of 3 resuscitative fluid therapies on hemostasis as measured by rotational thromboelastometry in dogs

“…Additionally, an in vivo study in humans undergoing cholecystectomy and treated with hetastarch 130/0.4 demonstrated reduced MCF that was thought to be related to reduced concentrations of fibrinogen . Animal studies have found similar results regarding impairment of MCF as well as effects on other TEM values such as CT, CFT, and alpha‐angle; however, no in vivo studies in dogs have evaluated resuscitative fluid effects on ROTEM whole blood analysis …”

“…The analyzer accommodates only one sample at a time. A previous study in dogs reported coefficients of variation for ROTEM variables; currently, insufficient information is available on the requirement for analyzing samples in duplicate . Any dog whose initial sample was evaluated by TEM at 60 min had all subsequent samples evaluated at 60 min.…”

“…Recent studies in both human and veterinary medicine have used TEM to evaluate the effects of various fluids on hemostasis. In vitro studies using canine, equine, and human blood have shown that fluids such as hetastarch, a synthetic colloid, and hypertonic saline, a hypertonic crystalloid, affect both viscoelastic coagulation and platelet function, and dilution alone may not explain the changes observed …”