EFFECT OF IRRIGATION FLUID COMPOSITION ON HEMOSTASIS IN MOUSE BLEEDING MODELS

Area of Science:

• Surgical Hemostasis
• Intraoperative Fluid Management
• Biomedical Engineering

Background:

• Intraoperative irrigation is vital for bleeding management.
• Normal saline (NS) is the standard, but its hemostatic properties are suboptimal.
• Investigating alternative irrigation fluids and additives is critical for improving surgical outcomes.

Purpose of the Study:

• To evaluate the hemostatic efficacy of different intraoperative irrigation fluids.
• To determine the impact of fluid temperature and additives (calcium, tranexamic acid) on hemostasis.
• To compare normal saline (NS), Lactated Ringer's (LR), and PlasmaLyte in bleeding models.

Main Methods:

• Utilized two mouse bleeding models: tail vein transection and liver laceration with abdominal irrigation.
• Compared NS, LR, and PlasmaLyte at room temperature and body temperature (37°C, 42°C).
• Assessed NS and LR supplemented with calcium (Ca 2+ ) or tranexamic acid (TXA).

Main Results:

• Warming irrigation fluids (NS and LR) to 37°C or 42°C significantly reduced bleeding times.
• LR demonstrated superior hemostasis compared to NS and PlasmaLyte at room temperature.
• NS supplemented with Ca 2+ or TXA showed improved hemostatic effects, approaching LR's efficacy.

Conclusions:

• Lactated Ringer's (LR) solution is superior to normal saline and PlasmaLyte for intraoperative hemostasis.
• The presence of calcium (Ca 2+ ) in irrigation fluid is a key factor in enhancing hemostatic ability.
• Warming irrigation fluids and using Ca 2+ -containing solutions like LR are recommended for optimal intraoperative bleeding control.