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Anesth Analg 2007;105:724-728
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000275198.84094.ad

CRITICAL CARE AND TRAUMA

Hydroxyethyl Starch: The Effect of Molecular Weight and Degree of Substitution on Intravascular Retention In Vivo

Takashi Hitosugi, DDS*, Toshiyuki Saito, MD, PhD*{dagger}, Sono Suzuki, DDS*, Ieko Kubota, DDS*, Emi Shoda, DDS*, Toru Shimizu, MD, PhD{ddagger}, and Yoshiyuki Oi, MD, PhD*

From the *Department of Anesthesiology, Nihon University Graduate School of Dentistry; {dagger}Department of Anatomy, Tokyo Medical University, Tokyo, Japan; and {ddagger}Department of Bioengineering, University of California, San Diego, La Jolla, California.

Address correspondence and reprint requests to Yoshiyuki Oi, MD, PhD, Department of Anesthesiology, Nihon University Graduate School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan. Address e-mail to oi{at}dent.nihon-u.ac.jp.

BACKGROUND: Hydroxyethyl starch (HES) solution is characterized by its mean molecular weight (MW), concentration, and degree of substitution (DS). This character varies worldwide.

METHODS: After binding fluorescein-isothiocyanate (FITC-HES), we evaluated the retention rate of three types of 6% HES in the A2 and V2 blood vessels of rat cremaster muscles using intravital microscopy in a mild hemorrhage model (10% of total blood volume). After blood withdrawal, we infused three types of FITC-HES: HES-A (MW 150–200 kDa, DS 0.6–0.68), HES-B (MW 175–225 kDa, DS 0.45–0.55), or HES-C (MW 550–850 kDa, DS 0.7–0.8) before determining the FITC-HES retention rate in the intravital microscope.

RESULTS: For V2, the FITC-HES retention rates 120 min after the start of the infusion were 27% ± 7.2% of baseline values (HES-A), 65% ± 9.1% (HES-B), and 86% ± 9.6% (HES-C); for A2 they were 27% ± 6.6%, 73% ± 10.2%, and 89% ± 8.7%, respectively. HES-B and HES-C were retained in the vessels longer than HES-A (P = 0.028 for V2, P = 0.038 for A2 between HES-B and HES-A; P = 0.022 for V2, P = 0.037 for A2 between HES-C and HES-A). There was no difference in the rate of disappearance from the vessels between HES-B and HES-C.

CONCLUSIONS: HES-B and HES-C are equally retained in the blood vessels. Middle-sized HES-B with low DS and middle substitution pattern stayed in the blood vessels as long as the large-sized HES. HES solutions of varying characters should be examined to optimize HES infusion.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2007 by the International Anesthesia Research Society.