Effects of Dextran-70 and Albumin on Coagulation in Experimental Hemorrhage in the Guinea Pig

Background: Dextran-70 is a more potent plasma volume expander than albumin but use has been
hampered because of it´s antithrombotic properties. However, also albumin has antithrombotic
properties and little is known about relative effects of these two colloids on coagulation in-vivo when
controlling for differences in efficacy as plasma volume expanders. Aim: Compare effects of dextran-
70 and albumin on coagulation at a dose resulting in equal plasma volume expansion. Methods:
Guinea pigs were subjected to a 25 ml/kg hemorrhage during 20 minutes and randomized to
resuscitation with either 6% dextran-70 at a dose of 15 ml/kg or 5% albumin at a dose of 25 ml/kg
(n=14 in each group) during 30 minutes starting one hour of shock. Blood samples were collected at
completion of resuscitation and at 4 hours. Plasma volume was measured using 125I-albumin and effect
on coagulation was evaluated using whole blood thrombelastography (TEG), measurement of
plasmafibrinogen and vonWillebrandfactor (vWF) concentrations and vWF GP1bA activity. Results:
Plasma volumes after resuscitation were similar in the groups at both time points. Dextran-70 resulted
in a transient prolongation of TEGclot amplification time (K) at completion of resuscitation compared
to albumin. TEG clot initiation (R) and strength (MA) did not differ between the treatments at any of
the time points. Albumin reduced vWF concentrations to a larger extent than dextran at both time
points whereas no difference in p-vWF GP1bA activity or in plasma fibrinogen and could be detected.
Conclusion: In equipotent doses with regard to plasma volume expansion, dextran-70 transiently
prolongsclot amplification time more than albumin whereas dextran-70 reducesplasma vWF
concentrations less than albumin.