The in vitro effects of fibrinogen concentrate and factor VIII on coagulopathy diluted by different fluids

Objective To investigate the effects of in vitro blood dilution with lactated ringer′s solution (RL), succinylated gelatin (GEL) and hydroxyethyl starch 130/0.4 (HES) on coagulopathy in the presence or absence of human fibrinogen (Fg) and human coagulation factor Ⅷ (FⅧ). Methods Blood collected from 18 patients scheduled for elective operations was diluted to 50%, followed by two different dose of Fg and FⅧ supplementation at 37 ℃. The influence was analyzed using TEG [The TEG variables of reaction time (R), coagulation time (K), growth angle (α) and maximum amplitude (MA) were determined]. Results TEG parameters changed significantly in all three groups after dilution. After dilution, the K values were increased and MA values were decreased in group RL compared to those values in whole blood (P 0.05). Conclusions Coagulation function was impaired by all three fluids with HES having the most profound impairment effect. Fg in vitro improved blood dilution induced coagulopathy. The effect of Fg supplementation depende on the kind of fluid. Coagulopathy induced by HES was completely correcterd only through high does Fg substation. Supplementation of FⅧ cannot improve blood dilution induced coagulopathy. Key words: In vitro; Hemodilution; Blood coagulation; Fibrinogen; Factor Ⅷ