NEIL ABRAMSON, M.D.
To the editor: Plasma expanders are commonly used in emergency medical care in patients with hypotension. Recent letters (1, 2) have recounted clinical bleeding in neurosurgical patients. Hydroxyethyl starch is a plasma expander that greatly increased the bleeding diathesis in a patient.
A 52-year-old black man was hospitalized because of hemoptysis from a tuberculous lesion of the left upper lobe. He also had a history of alcohol abuse and evidence of liver disease. Spur cell hemolytic anemia was shown by reticulocytosis, target cells, spur cells, splenomegaly, negative Coombs test, and hypohaptoglobinemia. Coagulation studies showed mild elevations in prothrombin and partial
ABRAMSON N. Plasma Expanders and Bleeding. Ann Intern Med. ;108:307. doi: 10.7326/0003-4819-108-2-307_1
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Published: Ann Intern Med. 1988;108(2):307.
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