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Oncotic, hemodilutional, and hemostatic effects of isotonic saline and hydroxyethyl starch solutions in clinically
P A Jones1, M Tomasic, P A Gentry
1Department of Clinical Studies, School of Veterinary Medicine, New Bolton Center, University of Pennsylvania, Kennett Square 19348-1692, USA.
Objective:
To evaluate the oncotic, hemodilutional, and hemostatic effects of IV infusions of a large volume of isotonic saline solution and 2 doses of 6% hydroxyethyl starch (HES) in clinically normal ponies.
Animals:
12 adult ponies.
Procedure:
Ponies were assigned to 3 treatment groups and received the following IV infusions: 80 ml of 0.9% sodium chloride/kg; 10 ml of 6% HES (in 0.9% sodium chloride)/kg; or 20 ml of 6% HES (in 0.9% sodium chloride)/kg. Blood samples were collected for determination of colloid oncotic pressure (COP), PCV, plasma total protein concentration, platelet count, von Willebrand factor antigen (vWf:Ag) activity, fibrinogen concentration, prothrombin time, activated partial thromboplastin time (APTT), and factor VIII coagulant (FVIII:C) activity. A rocket immunoelectrophoretic procedure was used for determination of vWf:Ag activity. A modification of the APTT assay was used for determination of FVIII:C activity. Cutaneous bleeding time was determined, using a template method.
Results:
Mean COP was persistently increased over baseline values in the face of hemodilution in HES-treated ponies. Prothrombin time, APTT, and fibrinogen concentrations decreased after infusions and vWf:Ag and FVIII:C activities were decreased in dose-dependent manner in HES-treated ponies. Though cutaneous bleeding time was not significantly affected in ponies of any group, a trend toward prolongation of bleeding time was evident in ponies receiving 20 ml of HES/kg. This trend appeared to be associated with marked decrement in vWf:Ag activity at this dosage.
Conclusions And Clinical Relevance:
Infusion of HES in clinically normal ponies increases COP, and exerts dose-dependent hemodilutional effects and dose-dependent effects on specific hemostatic variables. Thus, HES may be useful for resuscitative fluid treatment of horses.