Impact of the C2/C6 ratio of high-molecular-weight hydroxyethyl starch on pharmacokinetics and blood coagulation in pigs.

Details

Serval ID
serval:BIB_75938732CBB7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of the C2/C6 ratio of high-molecular-weight hydroxyethyl starch on pharmacokinetics and blood coagulation in pigs.
Journal
Anesthesiology
Author(s)
Schramm S., Thyes C., Frascarolo P., Buclin T., Burki M., Fisch A., Burmeister M.A., Asmis L., Spahn D.R.
ISSN
0003-3022
Publication state
Published
Issued date
2007
Peer-reviewed
Oui
Volume
107
Number
3
Pages
442-451
Language
english
Notes
Journal Article Research Support, Non-U.S. Gov't --- Old month value: Sep
Abstract
BACKGROUND: High-molecular-weight, low-substituted hydroxyethyl starch (HES) may not affect blood coagulation more than low-molecular-weight, low-substituted HES. The authors assessed in vivo the effect of a lowered C2/C6 ratio on pharmacokinetic characteristics and the impact on blood coagulation of high-molecular-weight, low-substituted HES. METHODS: A prospective, randomized, parallel study in 30 pigs compared HES 650/0.42/2.8 with HES 650/0.42/5.6. Before, during, and after infusion of 30 ml/kg body weight HES, blood samples were collected over 630 min to measure HES concentrations and plasmatic coagulation and to assess blood coagulation in whole blood by Thrombelastography (TEG; Haemoscope Corporation, Niles, IL). Pharmacokinetic parameters were estimated using a two-compartment model. RESULTS: The elimination constant was 0.009 +/- 0.001 min(-1) for HES 650/0.42/2.8 and 0.007 +/- 0.001 min(-1) for HES 650/0.42/5.6 (P < 0.001); the area under the plasma concentration-time curve was 1,374 +/- 340 min x g/l for HES 650/0.42/2.8 and 1,697 +/- 411 min x g/l for HES 650/0.42/5.6 (P = 0.026). The measured plasma HES concentrations were not different between HES 650/0.42/2.8 and HES 650/0.42/5.6. Both HES solutions equally affected blood coagulation: Thrombelastographic coagulation index decreased similarly at the end of infusion of HES 650/0.42/2.8 and at the end of infusion of HES 650/0.42/5.6 (P = 0.293). Also, activated partial thromboplastin and prothrombin times increased similarly for HES 650/0.42/2.8 and HES 650/0.42/5.6 (P = 0.831). CONCLUSION: Reducing the C2/C6 ratio in high-molecular, low-substituted HES solutions results in a slightly faster HES elimination. However, the blood coagulation compromising effect was unaffected.
Keywords
Albumins, Animals, Area Under Curve, Blood Coagulation, Blood Coagulation Tests, Hemoglobins, Hetastarch, Molecular Weight, Plasma Substitutes, Prospective Studies, Random Allocation, Structure-Activity Relationship, Swine, Thrombelastography, Time Factors
Pubmed
Web of science
Open Access
Yes
Create date
25/01/2008 10:45
Last modification date
20/08/2019 14:33
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