Prospective double-blind randomized study of the effects of four intravenous fluids on platelet function and hemostasis in elective hip surgery.

A prospective randomized double-blind study was performed to determine the effects of three colloids, Haemaccel, Gelofusine and albumin, and also saline on platelet activation, platelet aggregation (induced by adenosine diphosphate (ADP), epinephrine, collagen) platelet agglutination by ristocetin and other hemostatic variables in 55 patients undergoing primary unilateral total hip replacement. The fluids were administered according to normal clinical practice and assessments were made immediately before, at the end, and 2 h after the end of surgery. Surgery was accompanied by thrombin generation (increases in thrombin/antithrombin III complex, prothrombin F1 +2 fragment) platelet activation (betaTG) and compromised coagulation.

Can the effects of clinical reperfusion fluids on platelet aggregation in vitro predict the effects of administration of such fluids in a clinical study ex vivo?

Reperfusion fluids are administered routinely during surgical operations and following trauma. Studies performed wholly in vitro have indicated effects of some fluids on haemostasis through inhibition of platelet aggregation. Recently we performed a study to further evaluate the effects of reperfusion studies in vitro and also a study in a clinical setting to determine the extent to which the results of in vitro experiments can be extrapolated to the clinical situation.