Background: Hydroxyethyl starch (HES) has a known dose-dependant effect on
coagulopathy, The purpose of:this study was to determine the effect of HES
on coagulopathy after a period of hemorrhagic shock.
Methods: Anesthetized swine underwent a 15-minute, 40% blood volume hemorrh
age (28 mL/kg) and a 1-hour shock period, followed by resuscitation with sh
am resuscitation (group I); 6% HES, 15 mL/kg (group II); 5% albumin, 15 mL/
kg (group m); lactated Ringer's solution, 39 mL/kg, and 6% HES, 15 mL/kg (g
roup TV); and lactated Ringer's solution, 39 mL/kg, and 5% albumin, 15 mL/k
g (group V), Coagulation function was measured by bleeding time, prothrombi
n time, partial thromboplastin,time, fibrinogen, platelet count, and thromb
oelastography,
Results: Platelet counts decreased significantly (p < 0.05) in all resuscit
ation groups except the sham resuscitation group. A significant decrease in
platelets, fibrinogen levels, and maximum amplitude on thromboelastography
was related to a dilutional effect of the fluid given and not a result of
HES at the dose tested.
Conclusion: The linear dose-related coagulopathic effects of HES when given
at moderate doses does not seem to be worsened by prolonged periods of hem
orrhagic shock, The coagulopathy seen during resuscitation from hemorrhagic
shock seems to be a dilutional effect.