@article{ref1,
title="Hemodilution is Not Critical in the Pathogenesis of the Acute Coagulopathy of Trauma",
journal="Journal of surgical research",
year="2012",
author="Wohlauer, Max Valentin and Moore, Ernest E. and Droz, Nathan M. and Harr, Jeffrey and Gonzalez, Eduardo and Fragoso, Miguel and Silliman, Christopher C.",
volume="173",
number="1",
pages="26-30",
abstract="BACKGROUND: The acute coagulopathy of trauma is multifactorial, but generally believed to be aggravated by coexisting acidosis, hypothermia, and hemodilution. While acidosis and hypothermia have been extensively evaluated, there is a paucity of data on the independent role of hemodilution in this scenario. We therefore hypothesized that hemodilution will impair coagulation following experimental trauma and hemorrhagic shock. METHODS: Adult male Spraque-Dawley rats underwent trauma and hemorrhagic shock, followed by resuscitation with 2 × SBV using normal saline (NS). Thrombelastography (TEG) was performed before and after shock. RESULTS: In this trauma model, resuscitation resulted in a hemodilution of 50% (43% ± 4.05% versus 19.8% ± 3.96% Hct pre-shock versus post-shock , P < 0.0001). Despite the substantial hemodilution, there was no significant change in clot strength (12.96 ± 2.84 versus 11.79 ± 1.28 dynes/cm(2) G pre-shock versus post-shock, P = 0.13). Similarly, the onset of coagulation (R time) was not impaired (1.68 ± 1.74 s versus 1.75 ± 0.63 s R time pre-shock versus post-shock, P = 0.45). CONCLUSION: In the absence of hypothermia and acidosis, hemodilution (≤50%) has a trivial effect on coagulation following trauma and hemorrhagic shock. These data call to question the commonly held belief that hemodilution per se is critical in the development of post-injury coagulopathy.<p /><p>Language: en</p>",
language="en",
issn="0022-4804",
doi="10.1016/j.jss.2011.04.047",
url="http://dx.doi.org/10.1016/j.jss.2011.04.047"
}