In vitro effects of hypertonic saline solution on whole blood clotting

Mohammed Shnain Ali;

Karbala Journal of Medicine مجلة كربلاء الطبية
ISSN: 19905483 Year: 2013 Volume: 6 Issue: 1 Pages: 1568-1572
Publisher: Kerbala University جامعة كربلاء


background: hypertonic saline solution is frequently used to in the management ofhemorrhagic shock.Objective: To determine the effects of hypertonic (7%) saline solution on wholeblood coagulation (clotting) in vitro.Patients and methods: Ten healthy volunteers (5 males and 5 females with age range of 28-44 years) with no previous medical history of bleeding tendency and no medical history ofdrug intake were studied after their consent. Hypertonic (7%) saline was preparedimmediately before use. For each patient, 4 ml of venous blood sample was obtained andinvestigated as follows:Undiluted 450 µl of whole blood for baseline coagulation tests [prothrmbin Time (PT),activated partial thromboplastin time (APTT) and thrombin time (TT)]. After that, the sameabove tests were done after dilutions of whole blood (i.e whole blood replacement byhypertonic saline and isotonic saline for each dilution). An Isotonic (0.9%) saline dilutionserves as control. Blood volume replacements at 2.5%, 5%, 7.5% and 10% were done andstudied.Results: The baseline coagulation tests (PT, APTT, and TT) were normal for all 10 (100%)of subjects. At 2.5% and 5% of blood volume replacement PT, APTT and TT were slightlyprolonged, but showed no statistically significant difference between hypertonic (7%) salineand the control (isotonic saline) while PT, APTT and TT were prolonged in hypertonic (7%)saline with statistically significant difference (p<0.05) from isotonic (0.9%) saline at 7.5%and 10% of whole blood volume replacement in 10, (100%) of subjects.Conclusion: The study showed that hypertonic (7%) saline disturbs coagulation in vitro whenit replaces 7.5% or 10% of whole blood volume.


Hypertonic saline --- isotonic saline --- blood clot.