Effect Of Solvent/detergent-treated Plasma Oncoagulation And Hemorheology In Patients Undergoing Surgery

Objective To investigate the effect of solvent/detergent-treated plasma (SDP) on coagulation and hemorheology in patients undergoing surgery.Methods Sixty ASA â…  - â…¡ patients (aged 18-60 years and weighing 52-69 kg) undergoing elective abdominal or spinal surgery under general anesthesia were randomly divided into three groups: when the blood loss ≥ 50 ml, 20 patients receiving SDP (SDP group), 20 receiving fresh frozn plasma (FFP group) , and 20 receiving 10% hydroxyethyl starch (HES group). During the process of operation, the blood volume of the patients was maintained at normal level through infusing Lactic acid Ringer' solution, and red blood cells were infused if necessary. Perioperative blood pressure, electrocardiogram (ECG), Oxygen saturation (SO₂), expirated partial pressure of carbon dioxide (ETCO2), and central venous pressure (CVP) were monitored. Blood sample was collected from the central vein before infusion, 60 minutes and 120 minutes after infusion, respectively. And PT,APTT, TT,INR,FIB, TEG,AT-â…¢,PC,D-D,t-PA,PAI-1 and the antibody of virus were measured. Samples of SDP and FFP were collected after infusion.Results (1) No significant differences in TT, APTT, PT, INR, FIB and PLT count, or values of K, R, and angle before and after infusion (P>0.05) in the three groups were found. However, the strength of blood clot and the stability of thrombus increased significantly in groups of SDP and FFP, and they decreased significantly in the HES group after infusion (P<0.05). (2) After infusion, AT-â…¢ and Protein C decreased significantly in the HES group (P<0.05), and Protein C decreased significantly in the SDP group (P<0.05). However, no significant differences in Protein C and AT-â…¢ in the FFP group (P>0.05) or in AT-â…¢ in the SDP group (P>0.05) before and after infusion were found. (3) After infusion, D-Dimer increased significantly in groups of SDP and FFP (P<0.05), but no significant difference in D-Dimer before and after infusion was found in the HES group (P>0.05). After infusion, t-PA increased significantly in groups of SDP and FFP (P<0.05), and in the HES group,t-PA increased significantly at 60 minutes after infusion and recovered to the pre-infusion level at 120 minutes after infusion. PAI-1 increased significantly at 120 minutes after infusion in the SDP group (PO.05), increased significantly at 60 minutes and 120 minutes after infusion in the HES group (PO.05), but no significant difference was found before and after infusion in the FFP group (P>0.05). (4) HBV and LBV decreased significantly at 120 minutes after infusion compared with before infusion, in the SDP group (PO.05), and they decreased significantly at 60 minutes and 120 minutes after infusion in the HES group (.PO.05), but they had no significant change in the FFP group before and after infusion PV did not change significantly after infusion in all the three groups (P>0.05). Hct decreased significantly after infusion in the HES group (P<0.05) and had no significant change in groups of SDP and FFP (P>0.05). AI decreased significantly after infusion in groups of SDP and HES (P<0.05) but had no significant change in the FFP group (P>0.05). And no significant difference in DI and RI was found after infusion in all the three groups (P>0.05). (5) No evidence of virus infection related with SDP and FFP infusion was found in this study.Conclusions: (1) The intensity and stability of blood clot increase significantly after infusion in the SDP and FFP group and decrease significantly after infusion in the HES group. (2) The effects of SDP and FFP on anti-coagulation are better than HES, while similar effect is found between SDP and FFP. (3) Infusion of SDP helps to balance coagulation and fibrinolyiss, and the effect of SDP in reducing consumption of coagulation materials is superior to FFP and to 10% HES in patients undergoing surgery. (4) Infusion of SDP can decrease blood viscosity and erythrocyte aggregation index and improve hemorheology, which may improve the perfusion of tissues and organs. The effect of SDP and HES is similar and better than FFP. (5) There is no evidence of virus infection related with SDP and FFP infusion. Clinical safty and side effects of SDP are similar to FFP.