Influence of Different Intravascular Volume Therapies on Platelet Function in Patients Undergoing Cardiopulmonary Bypass

The effect of Hetastarch (670/0.75) in vivo on platelet closure time in the dog

“…HES solutions have been shown to compromise human platelet function in vitro 3–5 and in vivo 6–10 as measured by flow cytometry, 3,4,6,7 thromboelastography, 5,6,9–12 platelet aggregometry, 13,14 and platelet function analysis (PFA) 6–9,15 . Compared with other methods, PFA assesses platelet function under conditions of shear stress 16 and attempts to mimic the conditions under which a platelet plug is formed in vivo.…”

“…Studies have shown that HES solutions with a higher MW (>200 kDa) or a higher DS (>0.5), such as HES 670/0.75, have a more pronounced effect on platelet function compared with other types 7,8,10,13 . Clinically, some patient populations in human medicine have been shown to have higher rates of postoperative blood loss after HES administration 11–13,17–19 .…”

The Effect of 6% Hydroxyethyl Starch 130/0.4 on Hemostasis and Hemodynamic Efficacy in Off-pump Coronary Artery Bypass Surgery: a Comparison with 6% Hydroxyethyl Starch 200/0.5

“…1,2) Although several human studies confirmed that medium molecular weight HES (MW 200,000 to 250,000) with a lower degree of substitution does not have same negative effect on hemostasis, medium MW HES also compromises platelet contribution to hemostasis by reducing the availability of fibrinogen binding sites on activated platelets. [11][12][13] On the other hand, recent studies on the effect of HES specifications on hemostasis report that HES 130/0.4 has smallest effect compared to other HES specifications and similar with gelatin, which has minimal effect on coagulation. 3,14,15) In this study, TEG data in the HES 130/0.4 group were similar within the group except maximum amplitude (Fig.…”

Postoperative blood loss and transfusion associated with use of Hextend in cardiac surgery patients at a blood conservation center

“…Similar to retrospective studies, many of these studies were performed with Hespan and not HEX. 14,[17][18][19][20] Kuitunen and coworkers 18 compared high-and low-molecular-weight HES (20 mL/ kg) with albumin as the main component of the CPB priming solution and observed that while HES solutions were associated with abnormalities in thromboelastographic variables, there was no difference in transfusion requirements among the groups. 18 Other preparations of HES with differing molecular weights and substitutions have also been studied and implicated.…”