Korean J Crit Care Med.  2008 Dec;23(2):79-83. 10.4266/kjccm.2008.23.2.79.

Effect of 6% Hydroxyethyl Starch Solution on Coagulation Function in Patients with Major Burns

• Kwak IS
• Bae JY
• Kim KM

• KMID: 2228398
• DOI: http://doi.org/10.4266/kjccm.2008.23.2.79

Abstract

BACKGROUND
Patients with major burns require replacement of intravascular volume. Hydroxyethyl starch (HES) solutions are widely used to replace intravascular volume. Dilution with crystalloids or colloids and corresponding platelet dysfunction are known causes of perioperative bleeding tendencies. The aim of the current study was to evaluate the effect of crystalloid and colloid solutions on platelet function in patients with major burns.
METHODS
Forty patients scheduled for burn surgery were divided into 4 groups. The infusion was started with a Hartman solution infusion (group 1) from 7 A.M. until surgery. HES (6%, Voluven(R)) was infused in the following concentrations: 7 ml/kg (group 2), 10 ml/kg (group 3), and 15 ml/kg (group 4). The bleeding time (BT), prothrombin time (PT), prothrombin time international ratio (PT INR), activated partial thromboplastin time (aPTT), hemoglobin (Hb), platelet function analyzer-100 closing time (PFA CT), and platelet count (Plt) were measured.
RESULTS
Hartmann solution and HES had no significant effect on the BT, PT, PT INR, a PTT, Hb, and Plt. The post-operative PFA CT was significantly higher in group 4 than in group 3. In group 4, the PFA CT was significantly higher post-operatively compared to pre-operatively.
CONCLUSIONS
The use of high dose HES may increase the risk of bleeding tendencies in burn patients.

Keyword

blood coagulation; burn; colloid; crystalloid

MeSH Terms

Bleeding Time
Blood Coagulation
Blood Platelets
Burns
Colloids
Hemoglobins
Hemorrhage
Hetastarch
Humans
International Normalized Ratio
Isotonic Solutions
Partial Thromboplastin Time
Platelet Count
Prothrombin Time
Colloids
Hemoglobins
Hetastarch
Isotonic Solutions