National Scientific and Practical Centre of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev, Russian Ministry of Health, Samory Mashela str. 1, GSP-7, Moscow, 117198, Russia.
Center for Theoretical Problems of Physicochemical Pharmacology, Russian Academy of Sciences, Kosygina str. 4, Moscow, 119334, Russia.
Sci Rep. 2017 Apr 12;7(1):843. doi: 10.1038/s41598-017-00927-w.
Artificial plasma expanders (PEs) are widely used in modern transfusion medicine. PEs do not contain components of the coagulation system, so their infusion in large volumes causes haemodilution and affects haemostasis. However, the existing information on this effect is contradictory. We studied the effect of the very process of plasma dilution on coagulation and tested the hypothesis that moderate dilution with a PE should accelerate clotting owing to a decrease in concentration of coagulation inhibitors. The standard clotting times, a thrombin generation test, and the spatial rate of clot growth (test of thrombodynamics) were used to assess donor plasma diluted in vitro with various PEs. The pH value and Ca concentration were maintained strictly constant in all samples. The effect of thrombin inhibitors on dilution-induced hypercoagulation was also examined. It was shown that coagulation was enhanced in plasma diluted up to 2.0-2.5-fold with any PE. This enhancement was due to the dilution of coagulation inhibitors in plasma. Their addition to plasma or PE could partially prevent the hypercoagulation shift.
人工血浆扩容剂（PE）在现代输血医学中被广泛应用。PE 不含凝血系统成分，因此大量输注会导致血液稀释，并影响止血功能。然而，目前关于这种影响的信息存在矛盾。我们研究了血浆稀释过程对凝血的影响，并提出了一个假设，即适度的 PE 稀释由于凝血抑制剂浓度的降低，应该会加速凝血。使用标准凝血时间、凝血酶生成试验和空间血凝速度（血凝动力学试验）来评估用各种 PE 体外稀释的供体血浆。所有样本的 pH 值和 Ca 浓度都严格保持恒定。还检查了凝血酶抑制剂对稀释诱导的高凝作用的影响。结果表明，任何 PE 稀释 2.0-2.5 倍都能增强凝血。这种增强是由于血浆中凝血抑制剂的稀释。将它们添加到血浆或 PE 中可以部分防止高凝转移。
