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Hypertonic saline alters plasma clotting times and platelet aggregation
R L Reed1, T D Johnston, Y Chen
1Department of Surgery, University of Texas Medical School, Houston 77030.
The Journal of Trauma
|January 1, 1991
Summary
Hypertonic saline (7.5% HS) may increase bleeding by affecting blood clotting. This anticoagulant effect was observed in lab tests when HS replaced 10% or more of normal plasma.
Area of Science:
- Emergency Medicine
- Hematology
- Pharmacology
Background:
- Hypertonic saline (7.5% HS) is used for resuscitation in trauma and burn patients.
- Animal studies suggest HS may increase bleeding during hemorrhage, but the mechanisms are not fully understood.
Purpose of the Study:
- To investigate the potential anticoagulant effects of hypertonic saline (HS) in human plasma.
- To determine if HS affects blood clotting parameters and platelet aggregation.
Main Methods:
- Normal human plasma was diluted with either HS or normal saline (NS).
- Prothrombin times (PT) and activated partial thromboplastin times (APTT) were measured.
- Platelet aggregation studies were conducted.
Main Results:
- Significant deterioration in clotting tests and platelet aggregation occurred when plasma was diluted with 10% or more HS.
- Normal saline dilutions had no significant effect on clotting parameters.
- Strong correlations were found between clotting changes and sodium concentrations.
Conclusions:
- Hypertonic saline exhibits anticoagulant activity in vitro.
- This effect is not observed at typical resuscitation volumes but may be relevant with ongoing factor loss or dextran co-administration.