Primary hemostasis in hemodilution--2) Infusion solutions.

Abstract

Various infusion solutions are used during preoperative hemodilution or for substituting intraoperative blood loss. We examined the influence of saline 0.9%, albumin 5%, dextran 6% gelatin 3.5% and hydroxyethyl starch 6% (HES, mw 40,000 and 450,000) on primary hemostasis using the In-vitro bleeding test (IVBT) on composed blood samples of different hematocrit but constant platelet concentration. All infusion solutions tested caused longer bleeding times, depending on the volume used. Saline and albumin had the strongest effect, whereas high molecular weight HES or dextran showed hardly any impairment, if used in a quantity of less than 20% of the blood volume. Autologous plasma seems to be the best substitute in hemodiluted patients, at least if more than 20% of the blood volume has to be substituted by infusion solutions.