A comparison of the effects of a 4% modified fluid gelatin and a 6% hydroxyethyl starch on haemodilution, colloid osmotic pressure, haemostasis and renal parameters in healthy ponies.
Abstract: Adverse effects on renal health and haemostasis have been documented in human patients administered hydroxyethyl starches (HESs). Gelatins may represent useful substitutes should similar adverse effects be identified in horses. Objective: To compare the effects of a 4% modified fluid gelatin (MFG) with a 6% (130/0.4) HES on haemodilution, colloid osmotic pressure (COP), haemostasis and renal parameters in healthy ponies. Methods: Randomised crossover experiment. Methods: Three treatments (Treatment A: 10 ml/kg bwt HES; Treatment B: 10 ml/kg bwt MFG; Treatment C: 20 ml/kg bwt MFG) were administered to 6 healthy ponies with a 1 week washout period between treatments. Haematocrit, platelet count, total serum protein, COP, thromboelastography (TEG), prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen concentration were measured at baseline and at multiple time points up to 24 h post-infusion. Serum creatinine concentration, urine specific gravity (USG), urine protein:creatinine ratio (UPC), urine γ-glutamyltransferase:creatinine ratio (UGC) and urine sediment examination (USE) were performed before and at 24 h after each treatment, as well as at 1 week after the final treatment. Results: All treatments resulted in significant haemodilution and increases in COP. Treatment C had a significantly greater effect on haematocrit than the other treatments. The platelet count decreased with all treatments and was significantly lower following Treatment C compared with Treatment B. No clinically relevant differences were observed in any of the TEG parameters within or between treatments. No significant differences in PT, aPTT or fibrinogen concentration were observed among treatments. Serum creatinine concentration, UPC and UGC did not change significantly between pre- and post-study measurements. USG and USE remained within normal limits. Conclusions: Modified fluid gelatin could be considered as an alternative to HES for volume expansion and oncotic support. Neither MFG nor HES were associated with clinically significant adverse effects on haemostasis or renal parameters.
© 2016 EVJ Ltd.
Publication Date: 2016-07-28 PubMed ID: 27258662DOI: 10.1111/evj.12594Google Scholar: Lookup
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- Journal Article
- Randomized Controlled Trial
Summary
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The research compares the effects of modified fluid gelatin (MFG) and hydroxyethyl starches (HES) on blood dilution, osmotic pressure, blood clotting, and kidney function in healthy ponies. It finds that both MFG and HES can be useful for volume expansion and osmotic support, with no notable adverse effects on haemostasis or renal parameters.
Methodology
- In the study, a randomised crossover experiment using three treatments (one with HES, and two with different quantities of MFG) was carried out on six healthy ponies. The treatments were separated by a 1 week period to allow the efects of one treatment to dissipate before the next was administered.
- Several parameters were measured before and after each treatment including haematocrit (the proportion of blood occupied by red blood cells), platelet count, total serum protein, colloid osmotic pressure (COP), thromboelastography (TEG, a test used to assess the efficiency of blood coagulation), prothrombin time (PT, a measure for blood clotting), activated partial thromboplastin time(aPTT, a measure of the coagulation pathways), and fibrinogen concentration (an indication of coagulation potential of blood).
- Additionally, renal parameters were monitored based on urine tests including serum creatinine concentration, urine specific gravity (USG), urine protein:creatinine ratio (UPC), urine γ-glutamyltransferase:creatinine ratio (UGC) and urine sediment examination (USE).
Findings
- Results showed that all treatments led to significant haemodilution and increases in COP.
- The MFG treatment delivered at a higher concentration (Treatment C) had a significantly greater effect on the ponies’ haematocrit than the other two treatments. It also led to a decrease in platelet counts, which was more pronounced compared to the MFG treatment at a lower concentration (Treatment B).
- No significant differences were observed among various coagulation tests such as TEG parameters, PT, aPTT or fibrinogen concentration across the treatments.
- Regarding renal parameters, no variations were found in serum creatinine concentration, UPC, UGC, USG and USE between pre- and post-treatment measurements.
Conclusion
- The study concludes that modified fluid gelatin could be a viable alternative to HES for volume expansion and oncotic support since neither MFG nor HES was associated with clinically significant adverse impact on haemostasis or renal parameters in healthy ponies.
Cite This Article
APA
Gratwick Z, Viljoen A, Page PC, Goddard A, Fosgate GT, Lyle CH.
(2016).
A comparison of the effects of a 4% modified fluid gelatin and a 6% hydroxyethyl starch on haemodilution, colloid osmotic pressure, haemostasis and renal parameters in healthy ponies.
Equine Vet J, 49(3), 363-368.
https://doi.org/10.1111/evj.12594 Publication
Researcher Affiliations
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa.
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa.
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa.
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa.
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa.
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa.
MeSH Terms
- Animals
- Blood Substitutes / adverse effects
- Blood Substitutes / pharmacology
- Cross-Over Studies
- Female
- Gelatin / administration & dosage
- Gelatin / pharmacology
- Hemostasis / drug effects
- Horses / blood
- Horses / physiology
- Hydroxyethyl Starch Derivatives / administration & dosage
- Hydroxyethyl Starch Derivatives / pharmacology
- Osmotic Pressure / drug effects
Citations
This article has been cited 2 times.- Boyd CJ, Brainard BM, Smart L. Intravenous Fluid Administration and the Coagulation System.. Front Vet Sci 2021;8:662504.
- Kopper JJ, Kogan CJ, Cook VL, Schott HC 2nd. Outcome of horses with enterocolitis receiving oncotic fluid support with either plasma or hetastarch.. Can Vet J 2019 Nov;60(11):1207-1212.
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