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CARDIOVASCULAR ANESTHESIA

The Effects of High Molecular Weight Hydroxyethyl Starch Solutions on Platelets

Department of Anesthesiology and Intensive Care (B), Vienna Medical University, Austria

Address correspondence and reprint requests to Engelbert Deusch, MD, Department of Anesthesiology and Intensive Care (B), Vienna Medical University, Waehringer Guertel 18-20, 1090-Vienna, Austria. Address e-mail to engelbert.deusch{at}meduni.ac.at

Physicochemical characteristics of hydroxyethyl starch (HES) molecules determine their side effects on hemostasis. Our aim in the present experiments was to test the antiplatelet effect of novel high molecular weight HES. Citrated whole blood was hemodiluted in vitro (0% and 20%) with either HES 550 (Hextend®), HES 600 (6%Hetastarch-Baxter®), HES 200 (Elohäst®), or the solvent of Hextend® in its commercially available solution. The availability of glycoprotein IIb-IIIa was assessed on nonstimulated and on agonist-induced platelets using flow cytometry. Glycoprotein IIb-IIIa availability increased significantly after hemodilution with Hextend® and its solvent by 23% and 24%, respectively, but decreased in the presence of 6% Hetastarch-Baxter® and Elohäst® by 18% and 15%, respectively, with no significant difference between the latter two colloids. This study shows that Hextend® does not inhibit platelet function as anticipated by its high molecular weight and degree of substitution. The unexpected platelet stimulating effect of Hextend® is unique among the currently available HES preparations and may, at least in part, be induced by its solvent containing calcium chloride dihydrate (2.5 mmol/L). The platelet-inhibiting effect of 6%Hetastarch-Baxter® was not significantly different from that of medium molecular weight HES 200.

IMPLICATIONS: Hydroxyethyl starch (HES) solutions are widely used for fluid replacement in patients undergoing surgery, but they may compromise platelet function. The present study demonstrates that novel high molecular weight HES solutions differ from previous preparations in respect to side effects on platelet reactivity.

This article has been cited by other articles:

				J. Boldt, M. Wolf, and A. Mengistu A New Plasma-Adapted Hydroxyethylstarch Preparation: In Vitro Coagulation Studies Using Thrombelastography and Whole Blood Aggregometry Anesth. Analg., February 1, 2007; 104(2): 425 - 430. [Abstract] [Full Text] [PDF]

				P. Van der Linden and B. E. Ickx The effects of colloid solutions on hemostasis: [Les effets des solutions colloides sur l'hemostase] Can J Anesth, June 1, 2006; 53(6_suppl): S30 - S39. [Abstract] [Full Text] [PDF]

				V. G. Nielsen Effects of Hydroxyethyl Starch and Calcium on Platelet Activation Anesth. Analg., May 1, 2005; 100(5): 1538 - 1538. [Full Text] [PDF]

				E. Deusch and S. Kozek-Langenecker Effects of Hydroxyethyl Starch and Calcium on Platelet Activation Anesth. Analg., May 1, 2005; 100(5): 1538 - 1539. [Full Text] [PDF]

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