الفهرس 
Normal Hemostasis And Its RegulationOnly 14 pages are availabe for public view
 |  | from | 181 |  |  |
| | | from | 181 | | |
Abstract
The Effect of Administration of 6%Hydroxyethyl Starch (130/ 0.4( versus 6% Hydroxyethyl Starch (200/ 0.5( on Haemodynamics, Platelets- Mediated Hemostasis and Coagulation.
Soheir Abbas, MD, Hoda Omar, MD, Adel Mikhael, MD, Rasha Bondok, MD,
Neama Ahmed Gado Becher, M.Sc.
Department of Anaesthesiology and Intensive Care, Ain-Shams University Hospitals, Cairo, Egypt
Background: Fluid preloading has been considered a safe and effective method for preventing hypotension following spinal anaesthesia. The use of hydroxyethyl starch (HES) as a fluid replacement before peridural blockade may compromise blood coagulation. In this study the hemodynamic and coagulation effects of preloading with HES 130/0.4 and HES 200/0.5 under spinal block were examined.
Methods: Forty patients undergoing arthroscopic knee surgery were randomly assigned to two groups to receive 10 ml /kg of either 6% HES 130/0.4 (Group 1) or 6% HES 200/0.5 (Group 2) over 30 minutes. The hemodynamic effect was evaluated by MAP and HR. The coagulation measurement were evaluated by PT, aPTT, platelets counts, fibrinogen level, ATIII %, FVIII activity and VWF activity by VWF: RCO%. The platelets function was evaluated by platelets aggregation test with ADP and ristocetin A. Also haemoglobin, haematocrite and bleeding time were measured.
Results: There was no difference in patients’demographic data. Similar hemodynamic parameters were found in both groups. There was a significant decrease in both groups in Hb, haematocrite, platelets count, and fibrinogen and ATIII activity following fluid infusion. This change was insignificant between both groups. FVIII%, VWF: RCO% and platelets aggregation with ADP and ristocetin were significantly reduced in group 2 (HES 200/ 0.5) compared to group 1(HES 130/0.4).
Conclusion: HES 130/0.4 and HES 200/0.5 solution provide similar hemodynamic stability. Tetrastarch (HES130/0.4) provide less effects on coagulations and platelets functions.