The Effects of Colloid Pre-loading on Thromboelastography Prior to Caesarean Delivery: Hydroxyethyl Starch 130/0.4 versus Succinylated Gelatine

TÜRKER Y. G., Yilmazlar T., Mogol E. B., GURBET A., Dizman S., Gunay H.

JOURNAL OF INTERNATIONAL MEDICAL RESEARCH, vol.39, no.1, pp.143-149, 2011 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 39 Issue: 1
  • Publication Date: 2011
  • Doi Number: 10.1177/147323001103900115
  • Journal Name: JOURNAL OF INTERNATIONAL MEDICAL RESEARCH
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.143-149
  • Keywords: COLLOID PRE-LOADING, THROMBOELASTOGRAPHY, CAESAREAN SECTION, SPINAL ANAESTHESIA, IN-VITRO, SPINAL-ANESTHESIA, COAGULATION ANALYSIS, EPIDURAL-ANESTHESIA, IMPAIR HEMOSTASIS, RINGERS SOLUTION, CARDIAC-SURGERY, SECTION, HEMODILUTION, HYPOTENSION
  • Bursa Uludag University Affiliated: Yes

Abstract

This prospective, randomized, double-blind study compared the effects on thromboelastography (TEG) of pre-loading with two different colloid fluids prior to spinal anaesthesia for caesarean section. Healthy full-term parturients received either 500 ml 6% hydroxyethyl starch 130/0.4 (HES, n = 25) or 500 ml 4% succinylated gelatine (GEL, n = 25) prior to spinal anaesthesia. TEG parameters including reaction time (r-time), clot formation time (k-time), clot formation rate (alpha-angle) and maximum amplitude (MA) were measured immediately before and after pre-loading. Both groups had significantly shorter r-time and lower MA after pre-loading. The a-angle was significantly decreased after pre-loading with HES but not with GEL. No significant differences in k-time were induced pre-loading. In conclusion, pre-loading with HES or GEL was associated with a mild hypocoagulable effect in healthy parturients presenting for elective caesarean section; however, all TEG parameters in both groups remained within or very close to the normal range after pre-loading.