Jonas Jakub, Durila Miroslav, Vymazal Tomas
Department of Anaesthesiology and Intensive Care Medicine, University Hospital in Motol, Prague, Czech Republic.
Transfus Med Hemother. 2024 Oct 25;52(2):132-141. doi: 10.1159/000541772. eCollection 2025 Apr.
Crystalloid and colloid solutions commonly used in intensive and perioperative care can affect haemocoagulation status. This in vitro study assessed the impact of Plasma-Lyte, albunorm 5%, and Gelaspan 4% solutions on primary and secondary haemostasis using rotational thromboelastometry and platelet function analyser.
In this prospective study, we examined blood samples from 20 healthy volunteers using rotational thromboelastometry and platelet function analyser. Simultaneously, we analysed the blood samples subjected to 10% dilution using Plasma-Lyte, albunorm 5%, and Gelaspan 4% solutions.
Compared to controls, Plasma-Lyte shortened EXTEM-CT ( = 0.005) and reduced FIBTEM-MCF ( = 0.017). albunorm 5% prolonged EXTEM-CFT ( = 0.001), decreased EXTEM-alpha ( < 0.001) and MCF in EXTEM, INTEM, and FIBTEM tests ( < 0.001, = 0.038, = 0.001, respectively), along with MCE in the PLTEM test ( < 0.001). Gelaspan 4% also prolonged EXTEM-CFT ( < 0.001), decreased EXTEM-alpha ( < 0.001) and MCF in EXTEM, INTEM, and FIBTEM tests ( < 0.001, < 0.001, = 0.009, respectively), along with MCE in the PLTEM test ( < 0.001). Gelaspan 4% also reduced EXTEM-CT ( = 0.021). All solution prolonged CT in PFA Col/ADP ( = 0.003 for Plasma-Lyte, < 0.001 for albunorm and Gelaspan) and albunorm 5% also prolonged CT in Col/Epi ( = 0.003).
Plasma-Lyte had the least effect on secondary haemostasis, whereas albunorm 5% had the least effect among colloids. Gelaspan 4% adversely affected the propagation phase of coagulation, maximal strength and elasticity of the coagulum, and the level of functional fibrinogen. All solutions adversely affected platelet function in primary haemostasis, with Plasma-Lyte showing the least effect.
重症监护和围手术期护理中常用的晶体液和胶体液会影响血液凝固状态。这项体外研究使用旋转血栓弹力图和血小板功能分析仪评估了平衡液、5%白蛋白和4%明胶溶液对初级和次级止血的影响。
在这项前瞻性研究中，我们使用旋转血栓弹力图和血小板功能分析仪检查了20名健康志愿者的血样。同时，我们分析了用平衡液、5%白蛋白和4%明胶溶液进行10%稀释后的血样。
与对照组相比，平衡液缩短了EXTEM-CT（P = 0.005）并降低了FIBTEM-MCF（P = 0.017）。5%白蛋白延长了EXTEM-CFT（P = 0.001），降低了EXTEM-α（P < 0.001）以及EXTEM、INTEM和FIBTEM试验中的MCF（分别为P < 0.001、P = 0.038、P = 0.001），同时降低了PLTEM试验中的MCE（P < 0.001）。4%明胶也延长了EXTEM-CFT（P < 0.001），降低了EXTEM-α（P < 0.001）以及EXTEM、INTEM和FIBTEM试验中的MCF（分别为P < 0.001、P < 0.001、P = 0.009），同时降低了PLTEM试验中的MCE（P < 0.001）。4%明胶还缩短了EXTEM-CT（P = 0.021）。所有溶液均延长了PFA Col/ADP中的CT（平衡液为P = 0.003，白蛋白和明胶为P < 0.001），5%白蛋白还延长了Col/Epi中的CT（P = 0.003）。
平衡液对次级止血的影响最小，而5%白蛋白在胶体液中影响最小。4%明胶对凝血的传播阶段、凝块的最大强度和弹性以及功能性纤维蛋白原水平有不利影响。所有溶液均对初级止血中的血小板功能有不利影响，平衡液的影响最小。
