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Experimental effect of different dilutions of blood with human plasma protein fraction and large dose factor one on blood coagulation and chemistry in vitro
Department of Anesthesiology, ICU and Perioperative Medicine, Hamad General Hospital, Box 3050, Doha, Qatar / Department Clinical Anesthesiology, Weill Cornell Medicine, Doha, Qatar.
Department of Transplant Surgery, Hamad General Hospital, Doha, Qatar / Department of Surgery, Sohag University, Egypt.
University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Surgery, Hamad General Hospital, Doha, Qatar / Department of Medical Education, College of Medicine, Qatar University, Doha, Qatar. (Individ och samhälle VIDSOC, Individual and Society)ORCID iD: 0000-0003-0961-1302
Department of Anesthesiology, ICU and Perioperative Medicine, Hamad General Hospital, Doha, Qatar / Department Clinical Anesthesiology, Weill Cornell Medicine, Doha, Qatar.
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2019 (English)In: Indian Journal of Anaesthesia, ISSN 0019-5049, Vol. 63, no 12, p. 1015-1021Article in journal (Refereed) Published
Abstract [en]

Background and Aims: Human plasma protein fraction 5% (PPF5%) is an albumin-based colloid used to expand the plasma volume during volume deficiency. The current basic medical experimental study assessed in vitro coagulation of PPF5% solution and its effects on blood coagulation and chemistry. Methods: The study involved 20 volunteers, and each volunteer donated 20-50 ml of fresh blood. Three dilutions of blood with PPF5% dilutions were prepared (30, 50, and 70%). The fibrinogen dose required to correct coagulation in the 50% diluted samples was assessed (two doses used). The thromboelastogram (TEG) measured the haemostatic parameters (fibrinogen level, initiation of coagulation [R time], kinetics [K], acceleration of coagulation [α angle], maximum amplitude [MA] and coagulation index [CI]), and the ABL gas analyser measured the blood chemistry changes. Results: All dilutions showed significant TEG and blood chemistry changes when compared to controls. The two doses of fibrinogen corrected the clot formation speed with no significant difference in speed between the two doses. Acidosis measured by the strong ion gap (SID) and pH were significant for all dilutions when compared with the baseline. The 30% dilution remained within the lower normal acceptable value while 50% dilution was beyond the critical normal values. Conclusion: In vitro PPF5% to replace blood loss up to 50% dilution did not have significant coagulation and blood chemistry effects while coagulopathy should be expected in extreme dilutions (70%). Fibrinogen in a dose equivalent to 4 gm/70 kg adult improved clot strength at 50% dilution. 

Place, publisher, year, edition, pages
Wolters Kluwer, 2019. Vol. 63, no 12, p. 1015-1021
Keywords [en]
Blood coagulation and chemistry, fibrinogen level, human plasma protein fraction, thromboelastography
National Category
Anesthesiology and Intensive Care Cardiac and Cardiovascular Systems
Research subject
Individual and Society VIDSOC
Identifiers
URN: urn:nbn:se:his:diva-18056DOI: 10.4103/ija.IJA_398_19ISI: 000506379200009PubMedID: 31879426Scopus ID: 2-s2.0-85076812297OAI: oai:DiVA.org:his-18056DiVA, id: diva2:1382338
Note

Wolters Kluwer Medknow Publications

Available from: 2020-01-02 Created: 2020-01-02 Last updated: 2020-01-23Bibliographically approved

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