[Effects of preoperative acute hypervolemic hemodilution on
hypercoagulability of patients with colon cancer]
Liang H, Yang CX, Li H, Liu HZ, Wang HB
Ai Zheng. 2006 Oct ; 25(10): 1256-60

BACKGROUND & OBJECTIVE: Cancer patients have an increased risk of
thrombosis after operation because of a hypercoagulable status.
Therefore, anticoagulant treatment is necessary for patients with
hypercoagulability during perioperative period. This study was to
investigate the effect of acute hypervolemic hemodilution (AHHD) with
6% hydroxyethyl starch (HES), or 4% succinylated gelatin (GEL), or
lactated Ringer's (RL) solution before operation on the hypercoagulable
status and the occurrence of deep venous thrombosis (DVT) of patients
with colon cancer. METHODS: Sixty colon cancer patients with
hypercoagulable status underwent operation were randomized into HES,
GEL, and RL groups; each group contained 20 patients. The patients were
infused with HES, GEL, or RL solution respectively at a dose of 15
ml/kg within 30 min before operation. Preoperative coagulation function
was assessed by thrombelastography (TEG). DVT was diagnosed by the
color Doppler ultrasonic system. RESULTS: Acute hypervolemic
hemodilution with HES solution led to a significant decrease of
coagulation index (CI) at 30 min and 2 h after starting operation and 1
h after operation as compared with the prehemodilution value (P<0.01).
At 1 h after operation, CI was significantly lower in HES group than in
GEL group (P<0.05). At 30 min and 2 h after starting operation and 1 h
after operation, CI was significantly lower in HES group than in RL
group (P<0.05). Hemodilution with GEL solution lessened CI at 30 min
and 2 h after starting operation significantly as compared with the
prehemodilution value (P<0.01). At 30 min and 2 h after starting
operation, CI was significantly lower in GEL group than in RL group
(P<0.05). After operation, DVT in occurred 2 (10%) patients in HES
group, 3 (15%) in GEL group, and 10 (50%) in RL group (P<0.05).
CONCLUSION: Acute hypervolemic hemodilution with HES solution and GEL
solution can alleviate the hypercoagulability of colon cancer patients
during perioperative period and decrease the occurrence of DVT.


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