Molar substitution and C2/C6 ratio of hydroxyethyl starch: influence on blood coagulation

Details

Ressource 1Download: serval:BIB_66C4652B1D8D.P001 (139.73 [Ko])
State: Public
Version: author
License: Not specified
It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_66C4652B1D8D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Molar substitution and C2/C6 ratio of hydroxyethyl starch: influence on blood coagulation
Journal
British Journal of Anaesthesia
Author(s)
von Roten I., Madjdpour C., Frascarolo P., Burmeister M.A., Fisch A., Schramm S., Bombeli T., Spahn D.R.
ISSN
0007-0912 (Print)
ISSN-L
0007-0912
Publication state
Published
Issued date
2006
Volume
96
Number
4
Pages
455-463
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
BACKGROUND: Development of hydroxyethyl starches (HES) with a low impact on blood coagulation but a long intravascular persistence is of clinical interest. A previous in vitro study showed that low substituted high molecular weight HES does not compromise blood coagulation more than medium molecular weight HES. In the present study we assessed the individual effects on blood coagulation of molar substitution and C2/C6 ratio of a high molecular weight HES.
METHODS: Blood was obtained from 30 healthy patients undergoing elective surgery and mixed with six high molecular weight (700 kDa) HES solutions differing in their molar substitution (0.42 and 0.51) and C2/C6 ratio (2.7, 7 and 14) to achieve 20, 40 and 60% dilution. Blood coagulation was assessed by Thrombelastograph analysis (TEG) and plasma coagulation tests. Data were compared using a three-way analysis of variance model with repeated measures on the three factors.
RESULTS: Higher molar substitution compromised blood coagulation most (for all TEG parameters, P<0.05). The lowest C2/C6 ratio was associated with the lowest effect on blood coagulation; r (P<0.001), angle alpha (P=0.003) and coagulation index (P<0.001). No effect on k and maximum amplitude was observed (P for both >0.50). The higher molar substitution was associated with a lesser increase in PT (P=0.007) and a greater decrease in factor VIII (P=0.010). PTT, functional and antigenic von Willebrand factors were not significantly influenced by molar substitution (P for all >0.20). No significant differences between solutions with the same molar substitution but different C2/C6 ratios were found in plasma coagulation parameters (P for all >0.05).
CONCLUSIONS: TEG analysis indicates that high molecular HES with a molar substitution of 0.42 and a C2/C6 ratio of 2.7 has the lowest effect on in vitro human blood coagulation.
Keywords
Blood Coagulation/drug effects, Hemoglobins/analysis, Hydroxyethyl Starch Derivatives/chemistry, Hydroxyethyl Starch Derivatives/pharmacology, Plasma Substitutes/chemistry, Plasma Substitutes/pharmacology
Pubmed
Web of science
Open Access
Yes
Create date
13/07/2018 10:00
Last modification date
01/10/2019 7:18
Usage data