体外应用 6%羟乙基淀粉（HES）（130/0.4）溶液进行血液稀释对肝移植患者血栓弹力图分析的影响。

The effects of in vitro hemodilution with 6% hydroxyethyl starch (HES) (130/0.4) solution on thrombelastograph analysis in patients undergoing liver transplantation.

机构信息

Department of Anesthesiology and Pain Medicine, Inje University Haeundae Paik Hospital, Busan, Korea.

出版信息

Clin Transplant. 2011 May-Jun;25(3):450-6. doi: 10.1111/j.1399-0012.2010.01294.x. Epub 2010 Aug 30.

DOI:10.1111/j.1399-0012.2010.01294.x

PMID:20807229

Abstract

INTRODUCTION

The aim of this study was to determine the effects of in vitro hemodilution with 6% HES (130/0.4) solution on thrombelastograph(®) (TEG) parameters in whole blood samples from patients with end-stage liver disease (ESLD).

METHODS

Enrollment consisted of 95 patients with ESLD undergoing liver transplantation. Blood was diluted by 11%, 22%, and 33% with 6% HES (130/0.4) solution. Normal saline was used as a control diluent.

RESULTS

When blood was diluted by 33% with normal saline, only the reaction time (r) was increased (p < 0.0001) compared to the baseline value. When blood was diluted with 6% HES (130/0.4), 11% dilution decreased maximum amplitude (MA) (p = 0.003) compared to baseline. At 33% dilution, the r (p < 0.0001, vs. baseline) and K (p < 0.0001, vs. baseline; p < 0.0001, vs. normal saline) increased, and the MA, alpha angle, and coagulation index (p < 0.0001, vs. baseline; p < 0.0001, vs. normal saline) decreased.

CONCLUSION

Hemodilution with 6% HES (130/0.4) solution results in TEG abnormalities even with 11% hemodilution, in whole blood samples of patients with ESLD undergoing liver transplantation.

摘要

简介

本研究旨在确定体外用 6%羟乙基淀粉（130/0.4）溶液稀释对终末期肝病（ESLD）患者全血样本血栓弹力图（TEG）参数的影响。

方法

共纳入 95 例行肝移植的 ESLD 患者。用 6%羟乙基淀粉（130/0.4）溶液将血液稀释 11%、22%和 33%。生理盐水用作对照稀释液。

结果

与基线值相比，当用生理盐水将血液稀释 33%时，仅反应时间（r）延长（p < 0.0001）。当用 6%羟乙基淀粉（130/0.4）稀释血液时，与基线相比，11%稀释会降低最大振幅（MA）（p = 0.003）。在 33%的稀释度下，r（p < 0.0001，与基线相比；p < 0.0001，与生理盐水相比）和 K（p < 0.0001，与基线相比；p < 0.0001，与生理盐水相比）增加，而 MA、α角和凝血指数（p < 0.0001，与基线相比；p < 0.0001，与生理盐水相比）降低。