ORIGINAL ARTICLE

The effects of commonly used resuscitation fluids on whole blood coagulation

T J Coats¹, E Brazil², M Heron³

¹ Academic Unit of Emergency Medicine, Leicester University, Leicester, UK
² Emergency Department, Mater Misericordiae Hospital, Dublin, Ireland
³ Accident and Emergency Department, Royal London Hospital, London, UK

Correspondence to:
Correspondence to:
Professor T J Coats
Professor of Emergency Medicine, Leicester University, Leicester Royal Infirmary, Infirmary Square, Leicester LE 1 5WW, UK; t.coats{at}virgin.net

Objectives: Evidence on the effect of crystalloid and colloid resuscitation fluids on coagulation is confusing, with contradictory results from previous studies. This study was performed to test the effect on whole blood coagulation of a range of resuscitation fluids in vitro using a single method at a single dilution.

Methods: Seven resuscitation fluids were tested in vitro at a dilution of 40%. Whole blood coagulation was measured using a Sonoclot analyser.

Results: A crystalloid/colloid split of effect on coagulation in vitro was not seen. The time to clot formation with Gelofusine, dextran and hydroxyethyl starch was a greatly increased, whereas saline and Haemaccel had little effect, or were slightly procoagulant.

Conclusions: Some resuscitation fluids have a profound effect on coagulation. The confusion in the literature may result from the effect on coagulation being both fluid and dilution dependent, with no simple crystalloid/colloid split.

Abbreviations: ACT, activated clotting time; CR, clot rate; ED, emergency department; EP, emergency physician; TEG, thromboelastography; TTP, time to peak

Keywords: fluid therapy; resuscitation; whole blood coagulation

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This article has been cited by other articles:

• (2007). In neonates requiring intravascular volume resuscitation is the use of gelofusine safe and efficacious?. Arch. Dis. Child. 92: 1037-1038 [Full Text]  
• (2006). Choice of Resuscitation Fluid May Affect Blood Coagulation. JWatch Emergency Med. 2006: 2-2 [Full Text]