| The effect of colloid and crystalloid preloading on thromboelastography prior to Cesarean delivery. | |
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MedLine Citation:
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PMID: 17331930 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Fluid preloading with colloids reduces hypotension after spinal anesthesia for Cesarean delivery more effectively than crystalloids. However, the effects of fluid preloading regimens on coagulation in pregnant patients remain unresolved. The aim of this study was to compare the effects on coagulation of fluid preloading with 6% hydroxyethyl starch (HES) and lactated Ringer's (LR) solution using thromboelastography (TEG) with kaolin-activated whole blood in healthy pregnant patients prior to spinal anesthesia for Cesarean delivery. METHODS: After obtaining Ethics committee approval, 30 parturients were prospectively randomized prior to spinal anesthesia for elective Cesarean delivery to receive fluid preloading with either 1500 mL LR or 500 mL 6% HES over 30 min. Thromboelastography was performed immediately prior to and after fluid preloading. Standard TEG parameters were analyzed in terms of r time (min), k time (min), alpha angle (degrees) and maximum amplitude (mm). RESULTS: Group HES had statistically significant longer reaction times (r) and clot formation times (k) after fluid loading compared to baseline values (P < 0.05 respectively), although these post-fluid loading TEG parameters remained within a normal reference range. No significant differences in TEG values were seen after preloading within the LR group. CONCLUSION: Fluid preloading with 500 mL 6% HES in healthy parturients produced mild coagulation effects, as measured with TEG, prior to spinal anesthesia for Cesarean delivery. No significant effects on coagulation with TEG were observed following preloading with 1500 mL LR. |
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Authors:
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Alexander Butwick; Brendan Carvalho |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Canadian journal of anaesthesia = Journal canadien d'anesthésie Volume: 54 ISSN: 0832-610X ISO Abbreviation: Can J Anaesth Publication Date: 2007 Mar |
Date Detail:
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Created Date: 2007-03-02 Completed Date: 2007-06-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8701709 Medline TA: Can J Anaesth Country: Canada |
Other Details:
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Languages: eng Pagination: 190-5 Citation Subset: IM |
Affiliation:
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Department of Anesthesia, H3580, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, California 94305, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anesthesia, Obstetrical Anesthesia, Spinal Blood Coagulation / drug effects* Cesarean Section Female Hetastarch / pharmacology* Humans Hypotension / prevention & control Isotonic Solutions / pharmacology* Obstetric Labor Complications Plasma Substitutes / pharmacology* Pregnancy / blood Prospective Studies Statistics, Nonparametric Thrombelastography / methods* |
| Chemical | |
Reg. No./Substance:
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0/Isotonic Solutions; 0/Plasma Substitutes; 0/crystalloid solutions; 8022-63-7/Ringer's lactate; 9005-27-0/Hetastarch |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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