Vnitr Lek 2009, 55(1):27-36

Influencing hemostasis in substitute solution treatment

J. Máca^*, R. Kula, V. Chýlek

Anesteziologicko-resuscitační klinika FN Ostrava, přednosta prim. MUDr. Jan Jahoda

Hemostasis is an important intricately regulated homeostatic process. During the hospitalization a critically ill patient is often subjected to various external and internal stimuli which have abilities to influence the hemostasis. Administration of substitute solutions could be related to such an adverse effect. This paper tries to describe main mechanisms leading to impair the hemostatic balance during the fluid therapy and outline possibilities of their monitoring. The work also deals with every basic arteficial substitute solutions individually in term of their influence on coagulation. The goal was as well to point out certain controversial conclusions and problems emerging from the effort of synthesis of all information acquired from clinical publications related to the main topic. Generally it is possible to conclude that all substitutes have a potential to disturb coagulation. Tromboelastography belongs between the most accurate ways to measure coagulation disturbances and has several substantial advantages compared to classic examination. Character and degree of the influence depends on quantity, velocity of administration and type of used solution.

Keywords: substitute solutions; hemostasis; fluid therapy

Received: July 21, 2008; Accepted: September 3, 2008; Published: January 1, 2009  Show citation