Von Willebrand disease in patients with intracardiac high shear conditions: a PFA-100 analysis

Therefore, we examined the effect of HES 130 on thromboelastometry assessed whole blood coagulation after on-pump cardiac surgery. Method: Forty-five patients scheduled for elective primary cardiac surgery were included in the study. Immediately after admission to the cardiac surgical intensive care unit, the patients were allocated in random order to receive 15 mL/kg of 6% HES 130/0.4, 6% HES 200/0.5 or 4% Albumin solution. Modified thromboelastometry coagulation analysis (ROTEM®) using four activators was performed before the infusion, after the completion of the infusion and 2 hours thereafter. Results: Clot formation time was prolonged and maximum clot firmness decreased (all activators of ROTEM) immediately after completion of both HES solutions (P 0.05). Coagulation disturbances slightly recovered at 2 hours after HES completion, but not to the baseline level. No abnormalities in blood coagulation were observed after albumin infusion. The cumulative chest tube drainage until the first postoperative morning was not different between the groups. Conclusion: As a relatively rapid infusion HES 130/0.4 produces similar coagulation disturbance as HES 200/0.5 after cardiac surgery. In this clinical setting albumin seems not to impair haemostasis. The cumulative chest tube drainage at 16 h was comparable in the study groups. References: 1 Niemi TT, Suojaranta-Ylinen RT, Kukkonen SI, et al. Gelatin and hydroxyethyl starch, but not albumin, impair hemostasis after cardiac surgery. Anesth Analg 2006; 102: 998–1006. 2 Gallandat Huet RC, Siemons AW, Baus D, et al. A novel hydroxyethyl starch (Voluven) for effective perioperative plasma volume substitution in cardiac surgery. Can J Anaesth 2000; 47: 1207–1215.