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Related Experiment Videos

Are lactated Ringer's solution and normal saline solution equal with regard to coagulation?

Joachim Boldt1, G Haisch, S Suttner

  • 1Department of Anesthesiology and Intensive Care Medicine, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany. BoldtJ@gmx.net

Anesthesia and Analgesia
|January 29, 2002
PubMed
Summary

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Volume replacement with lactated Ringer's (RL) or 0.9% saline (SS) in major abdominal surgery caused mild, temporary hypercoagulability. No significant differences in coagulation or blood loss were observed between the two crystalloid solutions.

Area of Science:

  • Anesthesiology and Perioperative Medicine
  • Surgical Hemostasis
  • Fluid Resuscitation Strategies

Background:

  • Crystalloid solutions are commonly used for intravascular volume deficits.
  • Previous studies suggest crystalloid hemodilution may induce hypercoagulability.
  • The impact of different crystalloids on coagulation in surgical patients remains under-investigated.

Purpose of the Study:

  • To compare the effects of lactated Ringer's solution (RL) versus 0.9% saline solution (SS) on coagulation in patients undergoing major abdominal surgery.
  • To assess coagulation parameters using activated thrombelastography (TEG) over a 48-hour period post-volume replacement.

Main Methods:

  • A prospective, randomized study involving 42 patients undergoing major abdominal surgery.

Related Experiment Videos

  • Exclusive intravascular volume replacement with either RL (n=21) or SS (n=21) for 48 hours.
  • Activated TEG analysis (intrinsic, extrinsic, heparinase, aprotinin) performed at multiple time points (T0-T4).

    • Main Results:

    • Both RL and SS groups experienced mild, transient hypercoagulability immediately after surgery and up to 5 hours postoperatively, as indicated by intrinsic TEG changes.
    • No significant differences in coagulation parameters or blood loss were observed between the RL and SS groups.
    • Acidosis was noted exclusively in the SS-treated group; fibrinogen and antithrombin III decreased similarly in both groups due to hemodilution.

    Conclusions:

    • Intravascular volume replacement with crystalloids in major abdominal surgery leads to moderate and short-lived coagulation alterations.
    • No discernible differences in coagulation status or blood loss exist between RL and SS when used for volume replacement in this surgical context.