常用复苏液对全血凝血的影响。
The effects of commonly used resuscitation fluids on whole blood coagulation.
作者信息
Coats T J, Brazil E, Heron M
机构信息
Academic Unit of Emergency Medicine, Leicester University, Leicester, UK.
出版信息
Emerg Med J. 2006 Jul;23(7):546-9. doi: 10.1136/emj.2005.032334.
Abstract
OBJECTIVES
Evidence on the effect of crystalloid and colloid resuscitation fluids on coagulation is confusing, with contradictory results from previous studies. This study was performed to test the effect on whole blood coagulation of a range of resuscitation fluids in vitro using a single method at a single dilution.
METHODS
Seven resuscitation fluids were tested in vitro at a dilution of 40%. Whole blood coagulation was measured using a Sonoclot analyser.
RESULTS
A crystalloid/colloid split of effect on coagulation in vitro was not seen. The time to clot formation with Gelofusine, dextran and hydroxyethyl starch was a greatly increased, whereas saline and Haemaccel had little effect, or were slightly procoagulant.
CONCLUSIONS
Some resuscitation fluids have a profound effect on coagulation. The confusion in the literature may result from the effect on coagulation being both fluid and dilution dependent, with no simple crystalloid/colloid split.
摘要
目的
关于晶体液和胶体液复苏液对凝血功能影响的证据尚不明确，以往研究结果相互矛盾。本研究旨在采用单一方法、单一稀释度，在体外测试一系列复苏液对全血凝血功能的影响。
方法
七种复苏液在体外以40%的稀释度进行测试。使用Sonoclot分析仪测量全血凝血功能。
结果
未观察到体外凝血作用的晶体液/胶体液差异。使用佳乐施、右旋糖酐和羟乙基淀粉时，凝血形成时间大幅延长，而生理盐水和贺斯影响很小，或有轻微促凝作用。
结论
一些复苏液对凝血功能有显著影响。文献中的混淆可能是由于对凝血功能的影响既取决于液体类型，也取决于稀释度，不存在简单的晶体液/胶体液差异。
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