Document Detail


The effect of colloid and crystalloid preloading on thromboelastography prior to Cesarean delivery.
MedLine Citation:
PMID:  17331930     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Alexander Butwick; Brendan Carvalho
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
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:
Created Date:  2007-03-02     Completed Date:  2007-06-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  190-5     Citation Subset:  IM    
Affiliation:
Department of Anesthesia, H3580, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, California 94305, USA.
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MeSH Terms
Descriptor/Qualifier:
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:
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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