Abstract
Prior work showed that albumin resuscitation in man leads to decreased coagulation activity and coagulation protein content. These observations were tested in 20 splenectomized dogs shocked by control hemorrhage and resuscitated with the sequential infusion of: (1) 20 ml/kg balanced electrolyte solution (BES) or 5% albumin/BES; (2) shed blood; (3) 30 ml/kg BES or 5% albumin/BES; (4) 250 ml blood stored from the time of splenectomy. Either BES or 5% albumin/BES was given for the next 3 days. Coagulation activity (fibrinogen, plasminogen, factor VIII, and prothrombin) and coagulation protein content (factor VIII by specific canine antigen) were measured preshock, post resuscitation, and daily for 3 days. Albumin resuscitation significantly (p = greater than 0.05) reduced coagulation activity of fibrinogen (423 +/- 145 vs. 274 +/- 80 mg/dl SD), factor VIII:C (64 +/- 24 vs 42 +/- 16% SD), prothrombin (195 +/- 44 vs. 141 +/- 22% SD) but did not alter CPC of factor VIII:RAg (142 +/- 83 vs. 156 +/- 141% SD). Lower coagulation activity after 5% albumin/BES resuscitation in conjunction with no change in factor VIII:RAg content which is produced by the vascular endothelium suggest that impaired hepatic synthesis may lead to the reduced coagulation activity after albumin resuscitation.
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Selected References
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