The effects of haemodilution with albumin on coagulation in vitro as assessed by rotational thromboelastometry

Anaesthesia and Intensive Care
S PathiranaP C A Kam

Abstract

We investigated the in vitro viscoelastic changes of progressive haemodilution with 4% albumin compared with normal saline (NS) using rotational thromboelastometry (ROTEM(®), Pentapharm Co., Munich, Germany). Whole blood samples obtained from 20 healthy volunteers were diluted in vitro with 4% albumin or NS by 10%, 20% and 40%. Fibrinogen concentration and ROTEM(®) (EXTEM [screening test for the extrinsic haemostasis system], FIBTEM [EXTEM-based assay for the fibrin part of the clot]) variables including coagulation time, clot formation time (CFT), α-angle, maximum clot firmness and lysis index were measured in the undiluted sample and at each degree of haemodilution. There was no significant difference in fibrinogen concentration at equivalent haemodilutions with normal saline and 4% albumin solutions. Forty percent haemodilution with albumin significantly prolonged coagulation time (EXTEM P=0.007, FIBTEM P=0.0001) and significantly decreased lysis index (FIBTEM P=0.009) compared with NS. A significant decrease in maximum clot firmness from undiluted measurements (P=0.05) was observed at lower haemodilutions with albumin (20% with EXTEM, 10% with FIBTEM) compared with NS (40% with EXTEM and FIBTEM). The adverse effects of larg...Continue Reading

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Citations

Jun 24, 2015·Current Opinion in Critical Care·Sibylle A Kozek-Langenecker
May 15, 2018·International Journal of Laboratory Hematology·L HenschJ Teruya
Dec 9, 2017·Expert Review of Clinical Pharmacology·Ricard FerrerJosé Garnacho-Montero
Nov 25, 2020·International Journal of Laboratory Hematology·Andreas G TsantesArgirios E Tsantes
Apr 23, 2021·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Ciara HanleyJustyna Bartoszko
May 23, 2020·Food and Chemical Toxicology : an International Journal Published for the British Industrial Biological Research Association· Beata OlasMagdalena Bryś
May 4, 2021·Frontiers in Veterinary Science·Corrin J BoydLisa Smart
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