Activity of blood coagulation and fibrinolysis during and after hydroxyethyl starch (HES) colloidal volume replacement

Citation
Mn. Omar et al., Activity of blood coagulation and fibrinolysis during and after hydroxyethyl starch (HES) colloidal volume replacement, CLIN BIOCH, 32(4), 1999, pp. 269-274
Citations number
25
Categorie Soggetti
Medical Research Diagnosis & Treatment
Journal title
CLINICAL BIOCHEMISTRY
ISSN journal
00099120 → ACNP
Volume
32
Issue
4
Year of publication
1999
Pages
269 - 274
Database
ISI
SICI code
0009-9120(199906)32:4<269:AOBCAF>2.0.ZU;2-R
Abstract
Objectives: To examine the effect of medium molecular weight hydroxyethyl s tarch on protein C levels and the changes in the activation state of blood platelets, coagulation and fibrinolyis during and after 5 day of its infusi on. Design and Methods: Fifty male patients (mean age: 47 years, range 45-50 ye ars) who required prostatectomy for benign prostatic hyperplasia were divid ed into two equal groups. One group was given 15 mL/kg body weight (mean vo lume 1000 mL +/- 100 mL) of 6% hydroxyethyl starch (HES) 200/0.5, the other received an equal volume of 5% human albumin during the operation. Blood s amples were collected immediately before infusion (baseline values) and at 20, 40, 60, 90, 240, and 480 min after the infusion started then daily for the next 5 days postoperatively. Hematocrit, factor VIII:C, thrombin-antith rombin III complex; the anticoagulant protein C levels; the fibrinolytic pa rameters tissue type plasminogen activator (t-PA), and the fibrinolytic pro duct D-Dimer and the platelet aggregation activity were measured, Results: The data obtained did not detect any significant differences betwe en HES and human albumin in the plasma levels of thrombin-antithrombin ill complex, protein C, tissue-type plasminogen activator and the fibrin split products D-Dimer. Factor VIII:C and platelet aggregation were significantly lower in the hydroxyethyl starch group in comparison with albumin. Baselin e values were attained postoperatively for factor VIII:C and platelet aggre gation by the first and fifth days, respectively. Conclusion: The lowering effect of medium molecular weight hydroxyethyl sta rch on factor VIII:C would not be attributed to increased proteolytic activ ity of protein C on this coagulation cofactor because there is a nonsignifi cant change in protein C levels. Copyright (C) 1999 The Canadian Society of Clinical Chemists.