Biomaterial Database

Acute haemodilution and prostaglandin E1-induced hypotension: effects on the coagulation-fibrinolysis system. 1997

M Fukusaki, and T Maekawa, and M Miyako, and S Niiya, and K Sumikawa

Department of Anaesthesia, Nagasaki Rosai Hospital, Japan.

The effects of acute haemodilution, during prostaglandin E1 (PGE1)-induced hypotension, on the blood coagulation-fibrinolysis system were studied in 40 patients undergoing hip surgery. The patients were randomly divided into four groups of 10 patients each; Group A (control) received no induced hypotension or haemodilution, group B received hypotension alone, group C received haemodilution alone and group D received the combination of induced hypotension and haemodilution. Haemodilution in groups C and D was produced by drawing approximately 1000 mL 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 mean blood pressure was maintained at 55 mmHg. The mean dosage of PGE1 was 648 micrograms in group B and 661 micrograms in group D. In the control and PGE1-induced hypotension groups there was no significant change in platelet count (PLT), prothrombin time (PT), activated partial thromoplastin time (aPTT), fibrinogen (FIB), antithrombin-III (AT-III) or plasminogen (PLG). Haemodilution alone caused significant decreases in PLT (-43%), PT (+21%), FIB (-33%), AT-III (-21%) and PLG (-27%), and a significant increase in aPTT (+26%), whereas the combination of PGE1-induced hypotension did not cause any further change in these parameters. Serum-fibrin degradation products (FDP) significantly increased (+300%) and PLG significantly decreased (-30%) after surgery in all groups. 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.

UI	MeSH Term	Description	Entries
D007023	Hypotension, Controlled	Procedure in which arterial blood pressure is intentionally reduced in order to control blood loss during surgery. This procedure is performed either pharmacologically or by pre-surgical removal of blood.	Controlled Hypotension,Hypotension, Induced,Induced Hypotension
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D010952	Plasma Substitutes	Any liquid used to replace blood plasma, usually a saline solution, often with serum albumins, dextrans or other preparations. These substances do not enhance the oxygen- carrying capacity of blood, but merely replace the volume. They are also used to treat dehydration.	Blood Expanders,Plasma Volume Expanders,Expanders, Blood,Expanders, Plasma Volume,Substitutes, Plasma,Volume Expanders, Plasma
D001777	Blood Coagulation	The process of the interaction of BLOOD COAGULATION FACTORS that results in an insoluble FIBRIN clot.	Blood Clotting,Coagulation, Blood,Blood Clottings,Clotting, Blood
D005260	Female		Females
D005342	Fibrinolysis	The natural enzymatic dissolution of FIBRIN.	Fibrinolyses
D006438	Hemodilution	Reduction of blood viscosity usually by the addition of cell free solutions. Used clinically (1) in states of impaired microcirculation, (2) for replacement of intraoperative blood loss without homologous blood transfusion, and (3) in cardiopulmonary bypass and hypothermia.	Hemodilutions
D006490	Hemostatics	Agents acting to arrest the flow of blood. Absorbable hemostatics arrest bleeding either by the formation of an artificial clot or by providing a mechanical matrix that facilitates clotting when applied directly to the bleeding surface. These agents function more at the capillary level and are not effective at stemming arterial or venous bleeding under any significant intravascular pressure.	Antihemorrhagic,Hemostatic,Antihemorrhagics
D006622	Hip Prosthesis	Replacement for a hip joint.	Femoral Head Prosthesis,Femoral Head Prostheses,Hip Prostheses,Prostheses, Femoral Head,Prostheses, Hip,Prosthesis, Femoral Head,Prosthesis, Hip