Society of University Surgeons| Volume 74, ISSUE 2, P198-203, August 1973

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Stroma-free hemoglobin. I. Preparation and observations on in vitro changes in coagulation

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      Stroma-free hemoglobin solution has been proposed as a plasma substitute during acute resuscitation. Such a solution would have the theoretical advantages of carrying and unloading oxygen as well as expanding the circulating volume. One potential disadvantage of this solution is its interference with the normal clotting mechanism. The object of this report is to describe the anticoagulant properties of this solution and its correction. A mixture of citrated normal plasma and stroma-free hemoglobin was found to have a prolonged prothrombin time (PT) and a prolonged activated partial thromboplastin (APTT) time. Factor identification demonstrated a deficiency in Factor VIII activity. Factor assay revealed 18.5 percent of normal Factor VIII activity following citrated normal plasma-stroma-free hemoglobin incubation. Elimination of this anticoagulant activity was accomplished by adsorption of the stroma-free hemoglobin solution with hydrated aluminum hydroxide gel at 37 ° C. for one hour. We conclude that (1) an anticoagulant can be identified in stroma-free hemoglobin solution and (2) this anticoagulant activity can be abolished by adsorption with hydrated aluminum hydroxide gel.
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