REDUCED QUALITY OF CLOT FORMATION WITH GELATIN-BASED PLASMA SUBSTITUTES

We have studied, over a wide range of dilutions using techniques of cl ot weight, thrombelastography and scanning electron microscopy, the ph ysical properties of a blood clot formed in vitro when fresh blood was diluted with gelatin-based colloid solutions compared with crystalloi d controls. The colloid solutions tested (3.5% polygeline (Haemaccel) and 4% succinylated gelatin (Gelofusine)) produced clots that had redu ced median weight (P<0.001 and P=0.018, respectively) and reduced mean shear modulus (P<0.001) compared with crystalloid controls. Scanning electron microscopy showed that the fibrin formed a less extensive mes h in the presence of the gelatin-based colloids compared with crystall oid. Reduction in clot quality with gelatin-based colloids has not bee n noted previously and further work is needed to ascertain if this occ urs in vivo as these solutions are used frequently in patients who req uire full haemostatic competence.