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Related Experiment Videos

Does hemodilution enhance coagulability?

V Kretschmer1, A Daraktchiev, S Bade

  • 1Institute for Transfusion Medicine and Hemostaseology, University Hospital, Marburg, Germany. kretschv@mailer.uni-marburg.de

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
|December 18, 2004
PubMed
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Hemodilution effects on blood coagulation are complex. While some tests suggest enhanced clotting, others, like the Platelet Function Analyzer, reveal significant disturbances in primary hemostasis, especially with Hydroxy-ethyl starch.

Area of Science:

  • Hematology
  • Anesthesiology
  • Critical Care Medicine

Background:

  • Conflicting reports exist regarding blood coagulability changes during hemodilution.
  • Some studies indicate enhanced coagulation, while others show prolonged bleeding times in anemia.

Purpose of the Study:

  • To investigate the discrepancy in reported hemodilution effects on blood coagulation.
  • To analyze coagulation and primary hemostasis in diluted blood samples using various methods.

Main Methods:

  • Evaluated undiluted and diluted (20% saline, 6% HES, autologous PPP) anticoagulated blood samples.
  • Used TEG (thromboelastography), ball and hook coagulometers, and PFA-100 (Platelet Function Analyzer).

Main Results:

Related Experiment Videos

  • TEG with plasma dilution showed parameters indicative of enhanced coagulability (decreased r, increased MA).
  • HES and PTT-activated TEG indicated reduced coagulability.
  • Ball and hook coagulometers showed prolonged coagulation times, especially with saline.
  • PFA-100 demonstrated significant prolongation of closure time, indicating primary hemostasis disturbance, particularly with HES.

    • Conclusions:

    • TEG changes suggesting enhanced coagulability in plasma dilution may be methodical artifacts.
    • Hemodilution demonstrably disturbs primary hemostasis, as evidenced by PFA-100 results and existing literature.