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CARDIOVASCULAR ANESTHESIA

Hydroxyethyl Starch (HES) 130/0.4 Provides Larger and Faster Increases in Tissue Oxygen Tension in Comparison with Prehemodilution Values than HES 70/0.5 or HES 200/0.5 in Volunteers Undergoing Acute Normovolemic Hemodilution

Thomas Standl, MD^*, Marc-Alexander Burmeister, MD^*, Frank Schroeder, MD^*, Eike Currlin^*, Jan Schulte am Esch, MD, Marc Freitag, MD^*, and Jochen Schulte am Esch, MD^*

*Departments of Anesthesiology and Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany

Address correspondence and reprint requests to Thomas Standl, MD, Department of Anesthesiology, University Hospital Hamburg-Eppendorf, Martini Strasse 52, 20246 Hamburg, Germany. Address e-mail to standl{at}uke.uni-hamburg.de

Stable hemodynamics and improved rheology are important effects of hemodilution with hydroxyethyl starch (HES) infusions. One clinical indicator of improved rheology is increased tissue oxygen tension (tpO₂). In this prospective, randomized, double-blinded, crossover study, we examined the effects of acute normovolemic hemodilution with HES 130/0.4 on hemodynamics and skeletal muscle tpO₂ in comparison with conventional HES solutions. Twelve healthy volunteers were randomly enrolled in each group. At an interval of >8 days, volunteers donated 18% of their calculated blood volume within 30 min and randomly received 6% HES 130/0.4, 6% HES 70/0.5, or 6% HES 200/0.5 (crossover design) in a 1:1.2 ratio to their blood loss. Hemodynamic variables, tpO₂ in the quadriceps muscle, hematocrit, plasmatic HES concentrations, plasma viscosity, colloid osmotic pressures, and platelet aggregation were measured until 6 h after the infusion of HES. No differences were found among groups with respect to changes of hemodynamics, hematocrit, or platelet aggregation. With HES 200, colloid osmotic pressures and plasma viscosities were larger than after HES 70 (P < 0.05). HES 130 in comparison with HES 70 and 200 caused the fastest (30 min versus 90 min and 150 min after hemodilution; P < 0.05) and largest increase of tpO₂ in comparison to baseline (+93% versus +33% and 40%; P < 0.05). In healthy volunteers undergoing acute normovolemic hemodilution, the newly designed HES 130/0.4 showed a more pronounced and earlier increase of skeletal muscle tpO₂ in comparison with prehemodilution values than HES 70/0.5 or 200/0.5.

IMPLICATIONS: The effects of three different hydroxyethyl starch (HES) solutions on hemodynamics, rheology, and skeletal muscle tissue tension after acute normovolemic hemodilution were examined in awake volunteers. With HES 130/0.4, increases of tissue oxygen tension in comparison to baseline were larger and more rapid than with HES 70/0.5 or HES 200/0.5.

This article has been cited by other articles:

				T. A. Neff, L. Fischler, M. Mark, R. Stocker, and W. H. Reinhart The Influence of Two Different Hydroxyethyl Starch Solutions (6% HES 130/0.4 and 200/0.5) on Blood Viscosity Anesth. Analg., June 1, 2005; 100(6): 1773 - 1780. [Abstract] [Full Text] [PDF]

				F. Mertzlufft, F. Bach, R. Zander, and T. Standl Hydroxyethyl Starch (HES) 130/0.4 During Acute Normovolemic Hemodilution Increases Tissue Oxygen Tension Larger and Faster than HES 70/0.5 or HES 200/0.5 * Response Anesth. Analg., February 1, 2004; 98(2): 559 - 560. [Full Text] [PDF]