Original scientific paper

The influence of intravascular volume maintenance with a hydroxyethyl starch solution on coagulation in patients undergoing transurethral resection of the prostate

ELEONORA GOLUŽA orcid.org/0000-0001-6220-8614 ; Department of Anaesthesiology, Reanimatology and Intensive Medicine, University Hospital Centre-Zagreb, Croatia
KATARINA ŠAKIĆ ; Department of Anaesthesiology, Reanimatology and Intensive Medicine, University Hospital Centre-Zagreb, Croatia
NADA ORŠOLIĆ ; Department of Animal Physiology, Faculty of Science, University of Zagreb, Rooseveltov trg 6, HR-10000 Zagreb, Croatia
MARIJA GRKOVIĆ TOPALOVIĆ ; Department of Anaesthesiology, Reanimatology and Intensive Medicine, University Hospital Centre-Zagreb, Croatia
DINKO TONKOVIĆ ; Department of Anaesthesiology, Reanimatology and Intensive Medicine, University Hospital Centre-Zagreb, Croatia

Abstract

Background and Aims: Disorders of haemostasis by hydroxyethyl starch (HES) are mostly affected with large and highly substituted HES molecules or with longer duration and larger amount of HES infused. The development of HES solution with lower molecular weight and lower degree of substitution (HES 130/0.4) provides important advantage which affects less coagulation in vivo (8, 11, 13, and 16). We conducted a pilot study to evaluate influence of the HES 130/0.4 solution on coagulation parameters in patients with benign prostatic hyperplasia (BPH) undergoing transurethral
resection (TURP) in spinal anaesthesia.

Patients and Methods: Seventeen patients scheduled for TURP were
enrolled in this pilot study. For intravascular volume replacement, only HES 130/0.4 was used during and 1 hour after surgery. The venous blood samples have been taken 1 hour before surgery (as control) and 1 hour postoperative. Standard coagulation parameters prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, platelet count, fibrinogen were measured and whole blood coagulation was assessed using thromboelastography (TEG).

Results: Coagulation time (CT) and clot formation time (CFT) increased significantly postoperative both in Intrinsic Thromboelastography (INTEM) and Extrinsic Thromboelastography (EXTEM). Maximum clot firmness (MCF) decreased significantly in postoperative period in all TEG test INTEM, EXTEM and Fibrinogen Thromboelastography (FIBTEM) and alpha angle (α) decreased significantly both in INTEM and EXTEM. Despite significant postoperative changes of TEG parameters, they were
still within normal clinical range.

Discussion: We concluded that intravascular replacement exclusively
with HES 130/0.4 may be a safe choice for patients during TURP estimated by TEG.

Keywords

HES 130/0.4; coagulation; TEG; TURP

Hrčak ID:

67267

URI

https://hrcak.srce.hr/67267

Publication date:

31.3.2011.

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