Intravascular Persistence of Hydroxyethyl Starch in Man

Abstract

In two groups, each consisting of five healthy volunteers, 7 ml blood/kg body weight were exchanged with equal amounts of hydroxyethyl starch (HES) and dextran 60 solutions, respectively. Dextran 60 plasma levels, determined by the anthrone method, were undetectable after 4 weeks. The elimination of HES from the blood, determined by an immunological technique and by the anthrone method, had a very protracted course. Two weeks after infusion the HES plasma concentrations were 9% of the initial value and after 17 weeks they were still above the l% level. The prolonged intravascular persistence of HES in its commercially available preparation, and the possibility of tissue accumulation after repeated HES infusions were considered undesirable. The hypothesis that HES infusion causes an augmentation of serum α-amylase concentrations in man was confirmed. This effect should be borne in mind when HES solutions are given to patients in whom the diagnosis of acute pancreatitis might be considered.

Endothelial Accumulation of Hydroxyethyl Starch and Functional Consequences on Leukocyte-Endothelial Interactions

“…Consequently, the long-term exposure of cell cultures to 5 mg/ml FITC-HES results in a several fold increased uptake when compared to short-term incubation with even highest concentrations of 20 mg/ml. Regarding equivalent plasma levels of HES during different applications in vivo [24][25][26][27][28], it seems that intracellular accumulation of starch molecules may not play a role during acute volume resuscitation but appears to increase dramatically whenever HES is administered for several days even in small daily quantities.…”

Studies on Low-Dose Hydroxyethyl Starch Leukapheresis

“…Despite initial predictions that over 99% of HES given to donors intravenously would be eliminated from their blood within 16 days [14], later studies showed that some HES remained in serum 17 weeks after ad ministration [15]. Even after 1 year, small amounts of HES could still be detected in leukapheresis donors' serum [2,3], The present study shows that HES given during low-dose HES leukapheresis is elim inated at a faster rate than previously re ported [2,3] for the standard, higher-dose procedure, although the HES employed was identical to the product used in previous studies (Volex, McGaw Laboratories).…”

Hydroxyethyl Starch Inhibits Endothelium-Derived Relaxation in Porcine Coronary Arteries

“…Clinical plasma concentrations of HES are described as 5-20 mg/ml [11][12][13][14][15] . We chose the low concentration of 6 mg/ml because HES is widely used in small amounts to avoid side effects like bleeding complications [15,16] , renal impairment [17][18][19] and itching [20] .…”