Plasma volume expansion with Haemaccel does not impair haemostasis during reduction mammaplasty

Objectives. An in viva study under well-controlled conditions was undertake n to determine the effect of Haemaccel, a colloidal plasma volume expander, on normal haemostasis. Methodology. Twenty patients, who were admitted for reduction mammaplasty, were included in this study. A standardised anaesthesia protocol was follow ed with ail patients. Ten patients received 500 ml Haemaccel and 10 control s received 1 500 ml Ringer's lactate, a crystalloid solution. The solutions were administered intravenously during surgery over a period of 30 - 40 mi nutes. Standardised clinical observations and haematological tests were don e at the following time intervals: after anaesthesia but before infusion of the plasma substitute, immediately after infusion was completed, and 20, 4 0 and 60 minutes after infusion. Results: The blood pressure, pulse rate and O-2 saturation levels were not influenced by the treatment given. Haemodilution was similar for the two pa tient groups. The platelet count and plasma levels of fibrinogen decreased in parallel with haemodilution. Thereafter the platelet count gradually inc reased to pre-infusion counts at 60 minutes. The prothrombin time (PT), act ivated partial thromboplastin time (aPTT), thrombin time (TT) and platelet aggregation in response to adenosine diphosphate (ADP) and collagen were no t affected by the plasma volume expander given. Arachidonic acid-induced ag gregation decreased significantly after Ringer's lactate was given but did not change when Haemaccel was given. The bleeding time was prolonged slight ly, but not significantly, from 7.4 +/- 1.6 minutes to 8.8 +/- 1.6 minutes with Ringer's lactate and from 6.9 +/- 2.0 to 9.7 +/- 3.7 minutes with Haem accel. Conclusions. We could not find any scientific evidence that Haemaccel affec ts haemostasis; neither does it increase bleeding relative to Ringer's lact ate.