Assessment of coagulation with 6% hydroxyethyl starch 130/0.4 in cesarean section

Korean Journal of Anesthesiology, 04/27/2012

Oh CS et al. – Blood coagulation in parturients may be compromised at high dilution ratios of HES 130/0.4 (6%) to blood. Nevertheless, the infusion of 1,000ml of HES 130/0.4 (6%) in normal parturients did not significantly affect blood coagulation.


  • Forty parturients scheduled for cesarean sections were assigned randomly to receive either 500 or 1,000ml of HES 130/0.4 (6%).
  • Rotation thromboelastometry (ROTEM) measurements were performed before and after administering HES 130/0.4 (6%).
  • In addition, blood samples obtained from 20 randomly selected parturients were diluted 10% to 40% using HES 130/0.4 (6%), and ROTEM measurements were performed before and after dilution.
  • The changes from baseline and the effects of dilution were analyzed by ROTEM parameters.


  • Infusions of 500 or 1,000ml of HES 130/0.4 (6%) in the parturients altered the clot formation time, α angle, and maximal clot firmness, although all remained within normal ranges.
  • HES 130/0.4 (6%) affected in vitro blood coagulation in parturients' blood containing 10, 20, 30, and 40% HES.
  • The clotting time was prolonged at each dilution percentage, but remained within the normal range.
  • Other parameters showed an impairment of the coagulation system.

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