British Journal of Anaesthesia, Vol 81, Issue 2 198-202, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia
P. A. Evans, J. R. Glenn, S. Heptinstall and W. Madira
Fluid resuscitation aims to maintain intravenous volume without significant
effects on haemostasis. Several different types of i.v. fluid are available
for use in a patient who has suffered trauma, but there is evidence that
some resuscitation fluids may affect primary haemostasis. We have compared
the effects of two resuscitation fluids, Haemaccel and Gelofusin, on
platelet aggregation in vitro. These resuscitation fluids are both based on
gelatin but Haemaccel contains a high concentration of Ca2+ whereas
Gelofusin does not. Their effects on platelet aggregation in whole blood,
induced by a range of different agents, were determined using a
platelet-counting technique. Both Haemaccel and Gelofusin prevented
platelet aggregation induced by ristocetin (P < 0.05, Mann-Whitney). In
addition, Haemaccel proved to be a potent inhibitor of the platelet
aggregation that occurred in response to all of the other agonists
investigated: adenosine diphosphate, platelet-activating factor, collagen,
a thromboxane A2 mimetic (U46619) and epinephrine. The additional
inhibitory effects of Haemaccel were largely, but not completely,
attributable to its high Ca2+ content. Inhibition of platelet aggregation
by ristocetin may indicate a mechanism by which Haemaccel or Gelofusin may
contribute to impaired haemostasis. The presence in Haemaccel of high
concentrations of Ca2+, which is largely responsible for inhibition of the
aggregation induced by other agents, may provide an additional means by
which haemostasis could be impaired.
LABORATORY INVESTIGATIONS
Effects of gelatin-based resuscitation fluids on platelet aggregation
Accident and Emergency Department, Leicester Royal Infirmary, Leicester, LE1 5WW; Department of Chemical Pathology, Leicester Royal Infirmary, Leicester, LE1 5WW; Division of Cardiovascular Medicine, University Hospital, Queens Medical Centre, Nottingham
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