• Anthony M Roche, Michael F M James, Elliott Bennett-Guerrero, and Michael G Mythen.
• Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA. tony.roche@duke.edu
• J. Cardiothorac. Vasc. Anesth. 2006 Dec 1; 20 (6): 807-11.

ObjectivesThe primary objective of this study was to test the hypothesis that calcium alone does not account for the observed coagulation differences between saline-based and balanced electrolyte IV fluid preparations.DesignControlled, nonblinded, in vitro observational study.SettingUniversity-based anesthesia research laboratory.ParticipantsTen healthy volunteers.InterventionsThe volunteers donated fresh blood for in vitro 40% and 60% dilution with 6 intravenous fluid preparations (lactated Ringer's solution, human albumin solution, and 4 hydroxyethyl starch preparations). All saline-based fluids were supplemented with calcium chloride to obtain ionized concentrations >or=1.0 mmol/L.Measurements And Main ResultsAfter dilution of the fresh blood with the study fluids, samples were analyzed by using the Thrombelastograph. Three colloid preparations produced minimal coagulation derangement, even at 60% dilution (human albumin solution, tetrastarch in saline, and pentastarch in balanced electrolyte solution), whereas pentastarch in saline and hetastarch in balanced electrolyte produced a mildly hypocoagulable state at 60% dilution.ConclusionsThe different coagulation profiles between the 2 pentastarch preparations, as well as similar profiles of pentastarch in saline and hetastarch in balanced electrolyte solution, suggest that calcium is not solely responsible for previously observed effects.

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