British Journal of Anaesthesia, Vol 82, Issue 1 110-111, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia
T. G. Ruttmann, M. F. James and K. F. Wells
We have conducted an in vitro coagulation study consisting of two separate
groups of 20 subjects using the thrombelastograph. In the first group,
haemodilution was performed with a physiological balanced salt solution
similar to plasma, with the exception of calcium, and buffered to a normal
pH (Plasmalyte B) at 37 degrees C on blood obtained from consenting
volunteers. In the second group, a protein- poor body fluid (cerebrospinal
fluid (CSF)) obtained from parturient patients undergoing spinal
anaesthesia for Caesarean section was used as the diluent. There were
statistically significant differences between the warmed Plasmalyte B
treated samples and their untreated controls for all variables measured by
the thrombelastograph, except for maximum amplitude, and between the CSF
treated samples and their untreated controls for all variables. We conclude
that electrolyte and acid-base composition of the diluent fluid had no
effect on the observation that crystalloid haemodilution produces
hypercoagulability. The marked increase in coagulability produced by
addition of CSF cannot be explained on a simple haemodilution basis and
confirms previous suggestions of the presence of a procoagulant factor in
CSF.
JOURNAL ARTICLE
Effect of 20% in vitro haemodilution with warmed buffered salt solution and cerebrospinal fluid on coagulation
Department of Anaesthesia, University of Cape Town Medical School, Observatory, Cape 7925, South Africa
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