Peer-reviewed veterinary case report
How hydroxyethyl starch infusion affects blood clotting
By Botto, Angelica et al.·Published in BMC veterinary research·2018·Department of Veterinary Science, Italy·View original on PubMed →
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Original publication title: Thromboelastometric assessment of hemostasis following hydroxyethyl starch (130/0.4) administration as a constant rate infusion in hypoalbuminemic dogs.
- Species:
- dog
Plain-English summary
A group of 20 dogs with low albumin levels (hypoalbuminemia) were treated with a fluid called hydroxyethyl starch (HES) to help improve their blood's ability to clot. The dogs received either a lower or higher dose of HES over 24 hours. After treatment, the dogs showed some changes in their blood clotting ability, particularly in the group that received the higher dose, indicating a trend toward increased clotting. However, the treatment did not cause any bleeding problems. The study suggests that while the dogs had low albumin, not all were at risk for excessive clotting.
People also search for: dog hypoalbuminemia treatment · hydroxyethyl starch for dogs · dog blood clotting issues
Abstract
BACKGROUND: The primary aim was to evaluate by means of thromboelastometry (ROTEM) the effects of hydroxyethyl starch (HES) 130/0.4 administered as a constant rate infusion (CRI) on hemostasis in hypoalbuminemic dogs. The second aim was to use ROTEM analysis to detect whether all hypoalbuminemic dogs of our population were hypercoagulable. RESULTS: The study sample was 20 hypoalbuminemic dogs (albumin < 2 g/dl) with normal perfusion parameters and requiring intravenous fluid therapy. In order to support plasma colloid osmotic pressure, in addition to crystalloid, HES 130/0.4 was administered as a constant rate infusion at 1 ml/kg/h (group 1, n = 11) or 2 ml/kg/h for 24 h (group 2, n = 9). Blood samples were collected at baseline (T0) and 24 h postinfusion (T1); coagulation was assessed by standard coagulation profile (prothrombin time, activated partial thromboplastin time, and fibrinogen), and ROTEM analysis (in-TEM®, ex-TEM® and fib- TEM® profile). No statistically significant differences in ROTEM values in group 1 were observed (P > 0.05), whereas in group 2 statistically significant differences (P < 0.05) were found at T1 in the in-TEM® profile [decrease in clot formation time (P = 0.04) and increase in α angle (P = 0.02)] and in the ex-TEM® profile [increase in maximum clot firmness (P = 0.008) and α angle (P = 0.01)]; no changes were identified in the fib-TEM® profile. In both groups, a statistically significant decrease (P = 0.007) in hematocrit was noted, whereas no statistically significant differences in platelet count and standard coagulation profile were found. In group 2, a statistically significant increase in TS values (P = 0.03) was noted at T1. ROTEM tracings indicating a hypercoagulable state were observed in 7/20 dogs at T0 (5/11 in group 1 and 2/9 in the group 2). CONCLUSION: Our findings suggest that HES 130/0.4 administered as CRI does not cause hypocoagulability in hypoalbuminemic dogs. A trend toward hypercoagulability, probably related to the underlying diseases, was observed in group 2 at T1. Although all dogs were hyoalbuminemic, only 7/20 were hypercoagulable at T0, confirming the lack of correlation between albumin level and prothrombotic state.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/29386022/