Effects of plasma dilution on tissue-factor-induced thrombin generation and thromboelastography: partly compensating role of platelets.

摘要: BACKGROUND: Bleeding upon major surgery or severe trauma is treated by transfusion with crystalloids, colloids, plasma. This treatment, however, can lead to dilutional coagulopathy and impaired hemostasis. We investigated the suitability of two integrative coagulation tests measure hemostatic activity diluted STUDY DESIGN AND METHODS: Plasma from healthy donors was in vitro saline colloid (venofundin gelofusin). Coagulant response tissue factor monitored calibrated automated thrombin (CAT) generation rotational thromboelastography (TEG), detecting formation elastic fibrin clots. patients receiving fluid infusion during coronary artery bypass grafting (CABG) analyzed same assays. RESULTS: Optimal CAT TEG assays required presence 10 pmol per L 4 micromol phospholipid vesicles 100 x 10(9) platelets (PLTs) L. Strikingly, clot became at a higher extent dilution PLTs present (< =40% plasma) than =60% plasma). Colloids aggravated effect on formation, but FFP antagonized formation. In contrast, fibrinogen Factor (F)XIII only restored plasma samples undergoing CABG, assay variables were altered an corresponding volume infusion. CONCLUSION: Thrombin are reduced more 40 percent. either process, partly compensate for effect. colloids elasticity compared saline.