Valutazione dell'emostasi mediante tromboelastometria (ROTEM®) durante la rianimazione fluida con amido idrossietilico 130/0,4 (VOLUVEN®) o soluzione salina ipertonica 7,5% in cani con dilatazione/torsione gastrica

Colloidal solutions (e.g. HES, hydroxyethyl starch 130/0,4) or crystalloid (e.g. HS, hypertonic saline 7,5%) are commonly used for fluid resuscitation in critical patient, despite such fluids are potentially associated to hemostatic alterations. The aim of this study was to evaluate the impact on hemostasis of the administration of one intravenous bolus of HES (10 ml/Kg) or HS (4 ml/Kg) in dogs resuscitated for a gastric dilation volvulus (GDV). Blood samples were collected at baseline (T0) and at the end of bolus (T1), and processed for analysis by tromboelastometry (ROTEM) and by routine coagulation tests (PT, aPTT, fibrinogen). The study included 13 dogs in HES group and 10 dogs in the HS group. At T0, all dogs have ROTEM tracings classified as normal, except 1/13 dogs that was hypercoagulable, and 2/13 dogs that were hypocoagulable. In the group resuscitated by HES, the statistically significant differences between T0 and T1 were: increase of CFT (P=0,046) with reduction of MCF (P=0,002) in the ex-TEM profile, decrease of MCF (P=0,012) in the fib-TEM profile and reduction of fibrinogen (P<0,001). In the group resuscitated by HS, the statistically significant differences between T0 and T1 were: increase of CT (P=0,049) and CFT (P=0,02) with reduction of MCF (P=0,032) and α angle (P=0,037) in the ex-TEM profile, reduction of the α angle (P=0,036) in the in-TEM profile, reduction of MCF (P=0,017) in the fib-TEM profile, reduction of MCE platelet (P=0,021), reduction of fibrinogen (P=0,028) and increase in PT (P=0,004). Although these results are indicative of hypocoagulability, the mean values of the ROTEM variables results within the reference intervals in both groups and these alterations were not associated with relevant clinical signs of bleeding in our study population. Further studies are need to confirm the safety of HES or HS administration at incremental doses in dogs with GDV.