ACUTE HEMODILUTION AND PROSTAGLANDIN E1-INDUCED HYPOTENSION - EFFECTSON THE COAGULATION-FIBRINOLYSIS SYSTEM

The effects of acute haemodilution, during prostaglandin E1 (PGE1)-ind uced hypotension, on the blood coagulation-fibrinolysis system were st udied in 40 patients undergoing hip surgery. The patients were random ly divided into four groups of 10 patients each; Group A (control) rec eived no induced hypotension or haemodilution, group B received hypote nsion alone, group C received haemodilution alone and group D received the combination of induced hypotension and haemodilution. Haemodiluti on in groups C and D was produced by drawing approximate to 1000mL of blood and replacing it with the same amount of 6% hydroxyethyl starch. Induced hypotension in groups B and D was conducted with PGE1 and mea n blood pressure was maintained at 55 mmHg. The mean dosage of PGE1 wa s 648 mu g in group B and 661 mu g in group D. In the control and PGE1 -induced hypotension groups there was no significant change in platele t count (PLT), prothrombin time (PT), activated partial thromoplastin time (aPTT), fibrinogen (FIB), antithrombin-III (AT-III) or plasminoge n (PLG). Haemodilution alone caused significant decreases in PLT (- 43 %), PT (+ 21%), FIB (- 33%), AT-III (- 21%) and PLG (- 27%), and a sig nificant increase in aPTT (+ 26%), whereas the combination of PGE1-ind uced hypotension did not cause any further change in these parameters. Serum-fibrin degradation products (FDP) significantly increased (+ 30 0%) and PLG significantly decreased (- 30%) after surgery in all group s. It can be concluded that acute haemodilution to a haematocrit value of 22 +/- 2% causes a slight coagulopathy, which is not enhanced when combined with PGE1-induced hypotension.