Coagulopathy with the use of hetastarch in the treatment of vasospasm

E. R. Trumble, Jan Paul Muizelaar, J. S. Myseros, S. C. Choi, B. B. Warren

Research output: Contribution to journalArticle

50 Scopus citations

Abstract

The use of colloid agents to achieve hypervolemia in the prevention and treatment of postsubarachnoid hemorrhage (post-SAH) vasospasm is included in the standard of care at many institutions. Risk profiles are necessary to ensure appropriate use of these agents. In a series of 85 patients with recent aneurysmal SAH, 26 developed clinical symptoms of vasospasm. Fourteen of the 26 were treated with hetastarch for volume expansion while the other 12 received plasma protein fraction (PPF). Clinically significant bleeding pathologies were noted in six patients who received hetastarch as a continuous intravenous infusion. Hetastarch increased partial thromboplastin time from a mean of 23.9 seconds to a mean of 33.1 seconds (p < 0.001) in all patients who received infusions of this agent, while no effect was noted in the 12 patients who received PPF infusions. No other coagulation parameters were altered. This study shows an increase in coagulopathy with the use of hetastarch as compared with the use of PPF for the treatment of postaneurysmal vasospasm.

Original languageEnglish (US)
Pages (from-to)44-47
Number of pages4
JournalJournal of Neurosurgery
Volume82
Issue number1
StatePublished - 1995
Externally publishedYes

Keywords

  • aneurysm
  • coagulopathy
  • plasma substitutes
  • subarachnoid hemorrhage
  • vasospasm

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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    Trumble, E. R., Muizelaar, J. P., Myseros, J. S., Choi, S. C., & Warren, B. B. (1995). Coagulopathy with the use of hetastarch in the treatment of vasospasm. Journal of Neurosurgery, 82(1), 44-47.