Comparative evaluation of the effects of hydroxyethyl starch on coagulation state of patients during brain tumor surgeries in comparison to crystalloids by thromboelastography

Background: Hypercoagulability has been reported in primary brain tumors which can lead to thrombotic complications. Hydroxyethyl starch (hetastarch) is a synthetic colloid solution with adverse eff ects on blood coagulation. Th e aim of this study was to evaluate the protective eff ect of hetastarch in reducing thromboembolic events in these patients. Materials and Methods: In a double-blinded clinical trial, 60 brain tumor surgery patients were randomly divided into two groups and given 10 mL/kg hetastarch or normal saline during surgery. Blood coagulation was compared before and after infusion of these fl uids within and between groups by thromboelastography (TEG). Results: Th ere were no signifi cant diff erences in bleeding (P = 0.126), duration of surgery (P = 0.504), and fl uid intake (0.09L) between the two groups. Percentage of changes in R (R: Time to initiate fi brin formation), K (K: Measure of the speed taken to reach a specifi c level of clot strength), and Ly30 (Ly30: Percent of fi brin distraction after 30 minutes of clot formation) in the crystalloid group were –20.61 ± 26.46, –30.02 ± 49.10, and 1.27 ± 22.63, and that in the colloid group were 22.10 ± 26.11, 41.79 ± 37.15, and 59.09 ± 37.12, respectively. Deterioration in hemostasis during and after surgery was not observed. Conclusion: Th ere was a reduction in the speed of clot formation and increase in clot lysis in the hetastarch group. Coagulability was decreased in the colloid group. Infusion of 10 mL/kg hetastarch in brain tumor resection surgeries can probably decrease susceptibility of these patients to deep vein thrombosis (DVT) and thromboembolic events.