ORIGINAL ARTICLE

Impairment of coagulation by commonly used resuscitation fluids in human volunteers

T J Coats¹, E Brazil², M Heron³, P K MacCallum⁴

¹ Academic Unit of Emergency Medicine, Leicester University, Leicester, UK
² Emergency Department, Mater Misericordiae Hospital, Dublin, Ireland
³ Accident and Emergency Department, Barts and The London NHS Trust, London, UK
⁴ Department of Haematology, Queen Mary’s School of Medicine, London

Correspondence to:
Correspondence to:
T J Coats
Academic Unit of Emergency Medicine, Leicester University, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK;t.coatsAT{at}virgin.net

Background: This study compared the effects of two commonly used resuscitation fluids on whole blood coagulation.

Methods: 1000 ml of two resuscitation fluids each (saline and Gelofusine) were given to eight volunteers in a crossover design with a 2-week washout period. The effect on whole blood coagulation was assessed using the Sonoclot analyzer, a conventional coagulation screen and coagulation markers.

Results: No significant effect was found on whole blood coagulation by giving saline (time to peak clot increased by a mean of 106 s; (95% confidence interval (CI) –140 to 354), whereas Gelofusine delayed the time to peak by a mean of 845 s (95% CI 435 to 1255). By contrast, there was no change in the conventional coagulation screen with either fluid.

Conclusion: It was concluded that some resuscitation fluids have an effect on clot formation that is not shown by the conventional coagulation screen, but is disclosed only if the whole coagulation process is studied.

Abbreviations: ACT, activated clotting time; APTT, activated partial thromboplastin time; INR, international normalised ratio

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