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Related Experiment Videos

Moderate plasma dilution using artificial plasma expanders shifts the haemostatic balance to hypercoagulation.

Elena I Sinauridze1,2, Alexander S Gorbatenko3, Elena A Seregina4

  • 1National Scientific and Practical Centre of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev, Russian Ministry of Health, Samory Mashela str. 1, GSP-7, Moscow, 117198, Russia. sinaurid@list.ru.

Scientific Reports
|April 14, 2017
PubMed
Summary

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Artificial plasma expanders (PEs) enhance blood clotting when used in moderate volumes. This effect occurs because PEs dilute natural coagulation inhibitors in the blood, leading to faster clot formation.

Area of Science:

  • Transfusion Medicine
  • Hemostasis and Thrombosis
  • Biochemistry

Background:

  • Artificial plasma expanders (PEs) are crucial in transfusion medicine.
  • PEs lack coagulation factors, potentially impacting hemostasis upon infusion.
  • Existing data on PE effects on coagulation is conflicting.

Purpose of the Study:

  • To investigate the impact of plasma dilution by PEs on coagulation.
  • To test the hypothesis that moderate dilution accelerates clotting by reducing inhibitor concentrations.

Main Methods:

  • Assessed donor plasma diluted in vitro with various PEs.
  • Utilized standard clotting times, thrombin generation tests, and thrombodynamics (spatial clot growth rate).
  • Maintained constant pH and Ca+2 concentration; examined thrombin inhibitor effects.

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Main Results:

  • Plasma dilution up to 2.0-2.5-fold with any PE enhanced coagulation.
  • This hypercoagulation resulted from the dilution of plasma coagulation inhibitors.
  • Adding inhibitors to plasma or PEs partially mitigated the enhanced clotting.

Conclusions:

  • Moderate dilution of plasma with artificial plasma expanders accelerates coagulation.
  • This acceleration is attributed to the reduced concentration of endogenous coagulation inhibitors.
  • Understanding this mechanism is vital for optimizing transfusion strategies.