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KMID : 0604020080230020079
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Korean Journal of Critical Care Medicine
2008 Volume.23 No. 2 p.79 ~ p.83
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Effect of 6% Hydroxyethyl Starch Solution on Coagulation Function in Patients with Major Burns
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Kwak In-Suk
Kim Kwang-Min
Bae Ji-Young
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Abstract
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Background: Patients with major burns require replacement of intravascular volume. Hydroxyethyl starch (HES) solutions are widely used to replace intravascular volume. Dilution with crystalloids or colloids and corresponding platelet dysfunction are known causes of perioperative bleeding tendencies. The aim of the current study was to evaluate the effect of crystalloid and colloid solutions on platelet function in patients with major burns.
Methods: Forty patients scheduled for burn surgery were divided into 4 groups. The infusion was started with a Hartman solution infusion (group 1) from 7 A.M. until surgery. HES (6%, Voluven(R)) was infused in the following concentrations: 7 ml/kg (group 2), 10 ml/kg (group 3), and 15 ml/kg (group 4). The bleeding time (BT), prothrombin time (PT), prothrombin time international ratio (PT INR), activated partial thromboplastin time (aPTT), hemoglobin (Hb), platelet function analyzer-100 closing time (PFA CT), and platelet count (Plt) were measured.
Results: Hartmann solution and HES had no significant effect on the BT, PT, PT INR, a PTT, Hb, and Plt. The post-operative PFA CT was significantly higher in group 4 than in group 3. In group 4, the PFA CT was significantly higher post-operatively compared to pre-operatively.
Conclusions: The use of high dose HES may increase the risk of bleeding tendencies in burn patients.
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KEYWORD
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Blood coagulation, burn, colloid, crystalloid
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