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

Abstract

Controlled hemorrhagic shock in Greyhounds under anesthesia did not cause a significant change in PCT. Both HES 130/0.4 and 0.9% NaCl administration after induction of shock increased PCT. These results do not support that HES 130/0.4 causes relevant platelet dysfunction beyond hemodilution.

Comparison of the effects of a balanced crystalloid‐based and a saline‐based tetrastarch solution on canine whole blood coagulation and platelet function

“…However, a study that used in vitro dilutions of fluids to mimic the doses typically administered for resuscitation from shock (resulting in a greater dilution volume with saline than with HES), Ct PFA was more prolonged by saline than by tetrastarch . Likewise, in a hemorrhagic shock model comparing an IV bolus of 20 mL/kg tetrastarch to an IV bolus of 80 mL/kg of 0.9% NaCl administered over 20 minutes, no significant difference was found in Ct PFA between the groups . In this last study, Ct PFA was not prolonged above baseline in either group but a significant shortening of Ct PFA occurred after hemorrhage, which may have mitigated the adverse effects of HES or dilution on platelet function …”

“…Likewise, in a hemorrhagic shock model comparing an IV bolus of 20 mL/kg tetrastarch to an IV bolus of 80 mL/kg of 0.9% NaCl administered over 20 minutes, no significant difference was found in Ct PFA between the groups . In this last study, Ct PFA was not prolonged above baseline in either group but a significant shortening of Ct PFA occurred after hemorrhage, which may have mitigated the adverse effects of HES or dilution on platelet function …”

Abnormal platelet activity in dogs and cats – impact and measurement

“…, McBride et al . ). An in vitro study in healthy dogs also reported evidence of platelet dysfunction associated with anaemia secondary to haemodilution but its clinical importance was questioned (Clancey et al .…”

“…Intravenous fluid therapy is also known to cause platelet dysfunction. Some canine studies have suggested that only hypertonic saline, and not hydroxyl starches (HES) (specifically 130/0.4), result in statistically significant changes to platelet function beyond that associated with haemodilution alone (Wurlod et al 2015, McBride et al 2016). An in vitro study in healthy dogs also reported evidence of platelet dysfunction associated with anaemia secondary to haemodilution but its clinical importance was questioned (Clancey et al 2009a(Clancey et al , 2009b.…”

Effects of 6% tetrastarch or lactated Ringer's solution on blood coagulation in hemorrhaged dogs

“…A large volume of TS (40 mL/kg) decreased vWF concentration in comparison to the same volume of physiological saline in dogs, suggesting that primary hemostasis may be decreased by the colloid . However, recent studies have shown that TS administration after hemorrhagic shock does not alter primary hemostasis (ie, platelet function) beyond a dilutional effect in dogs . Contrasting with large molecular weight HES solutions, TS has little impact on platelet aggregation in dogs and humans .…”