Abstract:

BACKGROUND: There are few systemic research on coagulation for patients undergoing total hip arthroplasty with preloading hypertonic sodium chloride hydroxyletyy starch 40 (HSH40) currently.
OBJECTIVE: To compare the influence of HSH40 with succinylated gelatin on coagulation in patients during total hip arthroplasty.
METHODS: Forty-six ASAⅠ-Ⅱ patients planned for total hip arthroplasty were randomly divided into 2 groups (n=23): The patients in HSH40 group were infused 3 mL/kg hypertonic sodium chloride hydroxyletyy starch 40 (6 mL/min) or the patients in Gelofusine group were received 10 mL/kg succinylated gelatin (20 mL/min), all patients were anaesthetized with combined spinal epidural anesthesia. Value of fibrin formation time (R), blood clot formation time (k), maximum amplitude (MA), and coagulation index (CI), before (T1), 60 min after (T2) blood volume preloading and 2 hours postoperatively (T3) were measured by using thrombelastography. Prothrombin time (PT) and activated partial thromboplastin time (APTT) was detected in terms of a standard method.  
RESULTS AND CONCLUSION: Compared with T1, value of R, K, PT, APTT of two groups increased significantly at T2 (P < 0.05), K, APTT were lower for patients in HSH40 group than for patients in Gelofusine group at T2(P < 0.05). There were no statistical difference in coagulation parameters between T3 and T1 (P > 0.05). Preloading of 3 mL/kg HSH40 mildly influenced on coagulation, but the effects were weaker than succinylated gelatin, therefore, HSH40 could be safely applied in patients undergoing total hip arthroplasty.