Coagulation changes in patients of O and non-O blood group after acute hemodilution with 6% hydroxyethyl starch

Objective To evaluate the effects of acute hypervolemic hemodilution(AHH) with 6% HES 200/0.5 on blood coagulation of patients with O and non-O blood groups. Methods Thirty patients aged 18-65years old undergoing major surgery at a risk of large amount of blood loss during operation were enrolled in this prospective,randomized double-blinded clinical study. Patients were allocated to O group and non-O group.Arterial blood samples were taken before(T0),at end (T1) and 1h after AHH for the measurements of hematocrit(Hct),platelet count(Plt),prothrombin time(PT),activated partial thromboplastin time (APTT),coagulation factor Ⅷ activity (FⅧ∶C) and von Willebrand factor. Results Compared with the baseline,Hct and Plt decreased while PT and APTT were prolonged in both groups immediately and at 1h after fluid treatment (P0.05).APTT was longer in O group than that in non-O group[(38.9±7.6)s vs.(35.5±6.3)s],respectively (P0.05).FⅧ∶C at T0,T1 and T2 was lower in O group than that in non-O group [(86.1±28.8)%,(55.8±23.1)% and (60.0±23.0)% vs.(149.1±52.6)%,(93.1±42.9)% and (125.9±65.0)%](P0.05).gbACT was longer in O group than that in non-O group 1 hour after fluid treatment [(134.3±28.2)s vs. (127.1±25.6)s],respectively (P0.05).Conclusion FⅧ∶C and vWF concentrations are lower in patients of O blood group than those of non-O group. Our study suggested that acute hemodilution with hydroxyethyl starch 200/0.5 may interfere with coagulation in patients of O blood group much more than in those of non-O group. When using large dose hydroxyethyl starch 200/0.5 in patients of O blood group,this effect should be considered.