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In vitro effects of three formulations of hydroxyethyl starch solutions on coagulation and platelet function in horses
2013
Blong, April E. | Epstein, Kira L. | Brainard, Benjamin M.
Objective: To investigate the in vitro effects of 3 hydroxyethyl starch (HES) solutions on viscoelastic coagulation testing and platelet function in horses. Sample: Blood samples collected from 7 healthy adult horses. Procedures: Blood samples were diluted with various crystalloid and HES solutions to approximate the dilution of blood in vivo that occurs with administration of a 10 and 20 mL/kg fluid bolus to a horse (1:8 and 1:4 dilutions, respectively). Diluted samples were analyzed through optical platelet aggregometry, platelet function analysis, thromboelastography, and dynamic viscoelastic coagulometry. Colloid osmotic pressure and concentrations of von Willebrand factor and factor VIII:C were also determined for each sample. Results: For all HES products, at both dilutions, the colloid osmotic pressure was significantly higher than that in the respective carrier solutions. At the 1:4 dilution, nearly all HES solutions resulted in significant alterations in platelet function as measured via the platelet function analyzer and dynamic viscoelastic coagulometer. Significant decreases in platelet aggregation and factor concentrations were also evident. Fewer HES-associated changes were identified at the 1:8 dilutions. Conclusions and Clinical Relevance: Dilution of blood samples with all HES solutions resulted in changes in viscoelastic coagulation and platelet function that did not appear to be attributable to dilution alone. In vivo evaluations are necessary to understand the clinical impact of these in vitro changes.
Show more [+] Less [-]Evaluation and modification of the overall hemostasis potential assay for use with canine plasma
2013
Dengate, Anna L. | Morel-Kopp, Marie-Christine | Beatty, Julia A. | Barrs, Vanessa | Braddock, Jody A. | Churcher, Richard K. | Wilson, Bethany J. | Ward, Christopher M.
Objective—To optimize the overall hemostasis potential (OHP) assay for use with canine platelet-poor plasma and determine reference intervals in healthy dogs. Animals—40 healthy dogs. Procedures—Blood was collected from the dogs into citrated tubes, and platlet-poor plasma was obtained. The OHP assay and standard coagulation assays (prothrombin time, activated partial thromboplastin time, and fibrinogen concentration) were performed for each sample. The OHP assay outputs were tested for correlations with results of the standard coagulation assays, age, and sex. Results—Modifications to the published methodology for the OHP assay were required for use with canine plasma, with less coagulation activator (thrombin) and more fibrinolysis activator (tissue plasminogen activator) than used with human plasma. Male dogs had a higher OHP than did females. High fibrinogen concentrations were associated with increases in maximum optical density, OHP, and overall coagulation potential, and reduced prothrombin time was associated with increases in maximum optical density, overall coagulation potential, OHP, and maximum slope. Conclusions and Clinical Relevance—Results supported the use of the OHP assay as an accessible, cost-effective global coagulation assay. Further research is required to determine its clinical application as an alternative to thromboelastography or thrombin generation assays.
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