Mannitol and the combination of mannitol and gelatin impair whole blood coagulation and platelet function in vitro [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-86300

Mannitol and the combination of mannitol and gelatin impair whole blood coagulation and platelet function in vitro

Thomas Palmaers, Elke Krämer, Julia Hinsenkamp, Hendrik Eismann, Dirk Scheinichen, Paul Frank
Department of Anaesthesiology and Intensive Care, Medical School Hannover, Carl-Neuberg-Straße 1, D-30625 Hannover, Germany

Objective: Mannitol 20% and succinylated gelatin 4% are routinely used in neurosurgical procedures. Aim of this in vitro study was to explore the influence of both agents on blood coagulation and platelet function.
Methods: Blood from 21 healthy volunteers was obtained and then diluted into five groups: (1) 7% dilution with mannitol, (2) 10% dilution with gelatin (3) 17% dilution with isotonic balanced electrolyte solution, (4) 17% dilution with mannitol + gelatin and (5) undiluted blood. EXTEM, FIBTEM-Test were examined by rotational thrombelastometry via ROTEM®and thrombocyte aggregometry with the ASPI, ADP and TRAP-test were performed by Multiplate®.
Results: In the EXTEM-test Clot formation time, alpha-angle and maximum clot firmness were significantly reduced by mannitol and the combination of mannitol with gelatin. Platelet function tested in the ADP-TEST was also significantly reduced with this combination.
Conclusion: In this in vitro study clinically relevant dilutions of mannitol and gelatin showed a significant inhibition of whole blood coagulation and platelet function, which could be detrimental in neurosurgical settings.

Keywords: Mannitol, gelatin, thrombelastometry, platelet function, platelet aggregometry, coagulation




Corresponding Author: Thomas Palmaers, Germany


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