The Effects of Sodium Fructose Diphosphate on BLood Coagulation Reaction Time and Plasma Coagulation Factor Activity Tests in vitro

ObjectiveTo investigate the effects of sodium fructose diphosphate (FDP) on blood coagulation parameters, including reaction time and plasma coagulation factor activity, in both in vitro and in vivo models. MethodsThree thromboelastography systems (Maiketian, Lepu, Dingrun) were used to assess coagulation parameters (reaction time [R], clotting time [K], -angle, maximal amplitude [MA]) in blood samples spiked with varying FDP concentrations. An automatic coagulation analyzer quantified the activities of coagulation factors II, V, VII, VIII, IX, X, XI, and XII in FDP-treated plasma.Differences between FDP-treated and control groups were statistically compared. Linear regression analyzed correlations between FDP concentrations and coagulation parameters. For in vivo studies, New Zealand white rabbits received intravenous FDP (0.5, 1, 2, or 4 g/kg), and thromboelastography parameters were monitored at multiple time points post-administration (0.5-2 hours). ResultsThromboelastography demonstrated a strong positive correlation between FDP concentration and R values across all systems (P < 0.001; r = 0.988 [Maiketian], 0.999 [Lepu], 0.996 [Dingrun]). No significant associations were observed between FDP and K, -angle, or MA (P > 0.05). In vitro experiments revealed significant negative correlations between FDP concentration and activities of factors V (r = -0.995), VII (r = -0.990), IX (r = -0.989), XI (r = -0.997), and XII (r = -0.995) (P < 0.001), while factors II, VIII, and X remained unaffected (P > 0.05). In vivo administration demonstrated dose-dependent prolongation of R-time, reaching statistical significance (p < 0.05) at:0.5 g/kg: 0.5 hr post-dose,1 g/kg: 0.5-1.5 hr,2 g/kg: 0.5-1.5 hr,4 g/kg: 0.5-2 hr. ConclusionFDP significantly impacts coagulation testing outcomes both in vitro and in vivo, potentially through modulation of intrinsic pathway factors (V, VII, IX, XI, XII) and direct interference with clot initiation. These findings suggest clinically relevant anticoagulant properties that warrant further investigation.