Shin Hyun-Jung, Park Hee-Yeon, Na Hyo-Seok, Hong Jung-Pyo, Lee Gwan-Woo, Do Sang-Hwan
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam-si.
Department of Anesthesiology and pain medicine, Gil Medical Center, Gachon University College of Medicine, Incheon.
Blood Coagul Fibrinolysis. 2018 Jul;29(5):446-450. doi: 10.1097/MBC.0000000000000741.
: The current study aimed to measure the effects of Plasma-Lyte 148 solution on the blood coagulation profile according to the hemodilution level using rotational thromboelastometry (ROTEM) tests. Venous blood was collected from 12 healthy volunteers and divided into four specimen bottles, which were diluted at different levels with Plasma-Lyte 148 (0, 20, 40, and 60%). Following this, ROTEM tests were performed on the study samples. We found that as the hemodilution level increased, the ROTEM values showed a hypocoagulable pattern. The change rate of the maximum clot firmness (MCF) of INTEM was greater in the 40 (P = 0.015) and 60% (P < 0.001) dilutions than it was in the 20% dilution. Greater lengthening of the clot formation time of EXTEM was observed in the 60% dilution than it was in the 20% dilution (P < 0.001). The alpha-angle of EXTEM showed a greater decrease in the 60% dilution than it did in the 20% dilution (P < 0.001). A larger change rate of the MCF of EXTEM was observed in the 40 (P = 0.003) and 60% (P < 0.001) dilutions than it was in the 20% dilution. A greater decrease in the MCF of FIBTEM was identified in the 40 (P = 0.009) and 60% (P < 0.001) dilutions than in the 20% dilution. All coagulation pathways exhibited hypocoagulable patterns as the hemodilution level increased. However, most of the mean values of ROTEM parameters were within the normal reference range, except for those of the 60% dilution.
本研究旨在使用旋转血栓弹力图（ROTEM）测试，根据血液稀释水平来测量Plasma-Lyte 148溶液对凝血指标的影响。从12名健康志愿者采集静脉血，并将其分为四个标本瓶，用Plasma-Lyte 148以不同水平（0%、20%、40%和60%）进行稀释。随后，对研究样本进行ROTEM测试。我们发现，随着血液稀释水平的增加，ROTEM值呈现低凝模式。INTEM的最大血凝块硬度（MCF）在40%（P = 0.015）和60%（P < 0.001）稀释度时的变化率大于20%稀释度时。EXTEM的凝血形成时间在60%稀释度时比20%稀释度时延长更明显（P < 0.001）。EXTEM的α角在60%稀释度时比20%稀释度时下降更明显（P < 0.001）。EXTEM的MCF在40%（P = 0.003）和60%（P < 0.001）稀释度时的变化率大于20%稀释度时。FIBTEM的MCF在40%（P = 0.009）和60%（P < 0.001）稀释度时比20%稀释度时下降更明显。随着血液稀释水平的增加，所有凝血途径均呈现低凝模式。然而，除60%稀释度外，ROTEM参数的大多数平均值均在正常参考范围内。
