Home > Journals > Journal of Neurosurgical Sciences > Past Issues > Articles online first > Journal of Neurosurgical Sciences 2019 May 06

CURRENT ISSUE
 

JOURNAL TOOLS

eTOC
To subscribe
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Publication history
Reprints
Permissions
Cite this article as

 

 

Journal of Neurosurgical Sciences 2019 May 06

DOI: 10.23736/S0390-5616.19.04679-4

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Albumin combined with Mannitol impairs whole blood coagulation and platelet function in vitro

Thomas PALMAERS, Julia HINSENKAMP, Elke KRÄMER, Andreas LEFFLER, Markus FLENTJE, Lion SIEG, Hendrik EISMANN

Department of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany


PDF


BACKGROUND: The indication of hydroxyethyl starch is currently under critical discussion and albumin 5% (ALB) has an increasing use in the operating theatre. Therefore, ALB is routinely used in neurosurgical procedures and often combined with mannitol 20% (MAN). Purpose of this in vitro study was to determine the influence of the combination of MAN and ALB on blood coagulation and platelet function.
METHODS: 22 healthy volunteers were included into this study and 21 analysed. Blood was obtained and diluted into five groups: (1) 7% dilution with MAN, (2) 10% dilution with ALB (3) 17% dilution with isotonic balanced electrolyte solution, (4) 17% dilution with MAN + ALB and (5) undiluted blood as control group (CON). Rotational thrombelastometry via ROTEM® (EXTEM, FIBTEM-Test) and thrombocyte aggregometry via Multiplate® (ASPI, ADP and TRAP-test) were used to detect differences within the intervention groups and compared to the control group.
RESULTS: The maximum clot firmness in the FIBTEM test decreased under the normal range with the combination of MAN+ALB: 8mm (5.5-11) compared to CON: 15mm (12.5-20), p<0.05. Platelet function (ADP-test) showed significant decreases for ALB: 51 AUC (40-84) and MAN+ALB: 54 AUC (41-68) compared to CON: 92 AUC (75-101), p<0.05. Except in clotting time all other EXTEM tests of MAN+ALB subgroup showed significant impairment on blood coagulation compared to the control group.
CONCLUSIONS: In this in vitro study clinically relevant dilutions of MAN+ALB showed a significant inhibition of blood coagulation and platelet function. Further in vivo studies are necessary to confirm these results.


KEY WORDS: Mannitol - Albumin - Thrombelastometry - Platelet function - Platelet aggregometry - Coagulation

top of page