Related Experiment Video

Updated: Jul 11, 2026

Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
06:28

Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization

Published on: June 4, 2020

Effects of albumin 5% and artificial colloids on clot formation in small infants

T Haas1, A Preinreich, E Oswald

  • 1Department of Anaesthesiology and Intensive Care Medicine, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria. thorsten.haas@i-med.ac.at

Anaesthesia
|September 12, 2007
PubMed

Insights

Albumin, gelatine, and hydroxyethyl starch (HES) all impact pediatric coagulation. Gelatine showed fewer adverse hemostatic effects than HES, making it a potential albumin alternative in pediatric fluid replacement.

Area of Science:

  • Anesthesiology
  • Pediatric Critical Care
  • Hematology

Background:

  • Albumin is the textbook standard for pediatric fluid replacement, but artificial colloids are commonly used.
  • Concerns exist regarding artificial colloids' impact on hemostasis, with inconclusive data for 6% hydroxyethyl starch 130/0.4 (HES) in children and no data for gelatine.

Purpose of the Study:

  • To compare the hemostatic effects of albumin 5%, 4% modified gelatine solution, and 6% hydroxyethyl starch 130/0.4 (HES) in pediatric patients undergoing surgery.

Main Methods:

  • 42 children (3-15 kg) needing colloid replacement were randomized to receive albumin, gelatine, or HES.
  • Standard coagulation tests and rotational thromboelastography (ROTEM) were performed post-administration.

Main Results:

  • Routine coagulation tests showed comparable significant changes across all groups.
  • Activated partial thromboplastin time increased more with gelatine and HES.
  • ROTEM analysis revealed significant impairment in all groups, with HES causing the most pronounced negative effects on coagulation parameters, falling below normal ranges.

Conclusions:

  • Gelatine solution may be a preferable alternative to albumin from a hemostatic perspective in pediatric fluid replacement.
  • 6% hydroxyethyl starch 130/0.4 demonstrated the most significant adverse effects on the overall coagulation process in children.

More Related Videos

Description of a Swine Infant Model of Volume-Controlled Hemorrhagic Shock09:09

Description of a Swine Infant Model of Volume-Controlled Hemorrhagic Shock

Published on: November 3, 2023

Related Concept Videos

Coagulation01:06

Coagulation

Colloidal solids are solid particles suspended in solution. They are usually negatively charged, attracting a compact primary layer of positively charged ions, which attract more counterions to form an electrical double layer. Electrostatic repulsion between the charged double layers prevents the particles from colliding, stabilizing the colloids. These solids are often undesirable because they can contain toxins that are difficult to remove. Coagulation is a technique that helps aggregate and...
Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
Colloids and Suspensions01:17

Colloids and Suspensions

Children at play often make suspensions such as mixtures of mud and water, flour and water, or a suspension of solid pigments in water known as tempera paint. These suspensions are heterogeneous mixtures composed of relatively large particles visible to the naked eye or seen with a magnifying glass. They are cloudy, and the suspended particles settle out after mixing. The suspended particles in a suspension settle out after some time of mixing. The separation of particles from a suspension is...
Colloidal precipitates01:09

Colloidal precipitates

The high insolubility of some precipitates can result in an unfavorable relative supersaturation. This can lead to colloidal particles with a large surface-to-mass ratio, where adsorption is promoted. For instance, in the precipitation of silver chloride, silver ions are adsorbed on the surface of the colloidal particles, forming a primary layer. This layer attracts ions of opposite charge (such as nitrate ions), forming a diffuse secondary layer of adsorbed ions. This electric double layer...
Drug Distribution: Plasma Protein Binding01:29

Drug Distribution: Plasma Protein Binding

Drugs predominantly attach to plasma proteins, with only a small percentage remaining unbound. The unbound portion can be calculated as one minus the bound fraction. Acidic drugs form large, inactive complexes by reversibly binding to plasma albumin, which prevents them from diffusing across biological barriers. These drug-protein complexes act as reservoirs for the drugs. As the concentration of unbound drugs decreases, these complexes quickly dissociate to release the free drug, maintaining...
Colloids03:22

Colloids

Children at play often make suspensions such as mixtures of mud and water, flour and water, or a suspension of solid pigments in water known as tempera paint. These suspensions are heterogeneous mixtures composed of relatively large particles that are visible to the naked eye or can be seen with a magnifying glass. They are cloudy, and the suspended particles settle out after mixing. On the other hand, a solution is a homogeneous mixture in which no settling occurs and in which the dissolved...