The influence of intravascular volume maintenance with a hydroxyethyl starch solution on coagulation in patients undergoing transurethral resection of the prostate (CROSBI ID 177698)
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Goluža, Eleonora ; Šakić, Katarina ; Oršulić, Nada ; Grković Topalović, Marija ; Tonković, Dinko
engleski
The influence of intravascular volume maintenance with a hydroxyethyl starch solution on coagulation in patients undergoing transurethral resection of the prostate
The influence of intravascular volume maintenance with a hydroxyethyl starch solution on coagulation in patients undergoing transurethral resection of the prostate Sažetak 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.
HES 130/0.4; coagulation; TEG; TURP
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