Solutions and Emulsions Used for Intravenous Infusions

Richter, Wolfgang; Hedin, H.

doi:10.1007/978-3-642-69088-4_20

Cited by 8 publications

(6 citation statements)

References 157 publications

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“…Hydroxyethyl starch is widely used as a plasma substitute for autologous blood transfusion, haemodialysis, peripheral arterial stenosis, haemorrhagic shock, cerebral and cardiac ischaemia and hypoperfusion of the retina or the plancenta 47–54 . Hydroxyethyl starch has traditionally been considered to function by increasing colloid osmotic pressure.…”

Section: Fluid‐replacement Therapy For Heat Strokementioning

confidence: 99%

CEREBROVASCULAR DYSFUNCTION IS AN ATTRACTIVE TARGET FOR THERAPY IN HEAT STROKE^¶

Chen

Niu²,

Lin

2006

Clin Exp Pharma Physio

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2. All heat-stressed rodents, even under general anaesthesia, have hyperthermia, systemic inflammation, hypercoagulable state, arterial hypotension and tissue ischaemia and injury in multiple organs. These findings demonstrate that rodent heat stroke models can nearly mirror the full spectrum of human heat stroke. Experimental heat stroke fulfills the empirical triad used for the dignosis of classical human heat stroke, namely hyperthermia, central nervous system alterations and a history of heat stress.3. These physiological dysfunctions and survival during heat stroke can be improved by whole-body or brain cooling therapy adopted immediately after the onset of heat stroke.4. However, in the absence of body or brain cooling, these heat stroke reactions can still be reduced by the following measures: (i) fluid replacement with 3% NaCl solution, 10% human albumin or hydroxyethyl starch; (ii) intravenous delivery of antiinflammatory drugs, free radical scavengers or interleukin-1 receptor antagonists; (iii) hyperbaric oxygen therapy; or (iv) transplantation of human umbilical cord blood cells.5. In addition, before initiation of heat stress, prior manipulations with one of the following measures was found to be able to protect against heat stroke reactions: (i) systemic delivery of α α α α-tocopherol, mannitol, inducible nitric oxide synthase inhibitors, mu-opioid receptor antagonists, endothelin ET A receptor antagonists, serotoninergic nerve depletors or receptor antagonists, or glutamate receptor antagonists; or (ii) heat shock portein 72 preconditioning.6. There is compelling evidence that cerebrovascular dysfunction is an attractive target for therapy in heat stroke.

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Section: Fluid‐replacement Therapy For Heat Strokementioning

confidence: 99%

CEREBROVASCULAR DYSFUNCTION IS AN ATTRACTIVE TARGET FOR THERAPY IN HEAT STROKE^¶

Chen

Niu²,

Lin

2006

Clin Exp Pharma Physio

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“…Hydroxyethyl starch (HES) is widely used as a plasma substitute for autologous blood transfusion, hemodialysis, peripheral arterial stenosis, hemorrhagic shock, cerebral and cardiac ischemia, and hypoperfusion of the retina or the placenta (5)(6)(7)(8)(9)(10)(11)(12). HES has traditionally been considered to function by increasing colloid osmotic pressure.…”

Section: Introductionmentioning

confidence: 99%

Hydroxyethyl Starch Produces Attenuation of Circulatory Shock and Cerebral Ischemia During Heatstroke

Liu¹,

Ke²,

Chen³

et al. 2004

Shock

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We hypothesized that hydroxyethyl starch (HES), which maintains colloid osmotic pressure and potentially "seals" capillary leaks, would ameliorate circulatory shock and cerebral ischemia during heatstroke in a rat model. Animals under urethane anesthesia were exposed to high ambient temperature (Ta) of 42 degrees C until mean arterial pressure and local cerebral blood flow in the striatum began to decrease from peak level, which was arbitrarily defined as the onset of heatstroke. Control rats were exposed to 24 degrees C. In rats treated with 1 mL/kg, 11 mL/kg, or 22 mL/kg of normal saline (NS) immediately after the onset of heatstroke, the values for survival time (interval between the initiation of heatstroke and animal death) were found to be 21 +/- 2, 36 +/- 9, or 92 +/- 7 min, respectively. Intravenous administration of 11 mL/kg of HES (about 5 times the volume-expanding effect of 11 mL/kg of NS), but not 2 mL/kg of HES (about the same volume-expanding effect as 11 mL/kg NS), significantly increased the survival time from the control values of 36 +/- 9 min to new values of 181 +/- 13 min. In NS (11 mL/kg)-treated or HES (2 mL/kg)-treated rats after heatstroke onset, the values for mean arterial pressure, stroke volume, total peripheral resistance, cerebral blood flow, blood pH, Paco2, Pao2, and brain Po2 were significantly lower than those of rats kept at Ta 24 degrees C. In contrast, the values for colonic temperature and the extracellular concentrations of glutamate, glycerol, and lactate/pyruvate ratio obtained in striatum were significantly higher than those of controls. The heatstroke-induced arterial hypotension, decreased stroke volume and total peripheral resistance, decreased blood pH and Pao2, decreased brain Po2, and increased levels of striatal glutamate, glycerol, and lactate/pyruvate ratio in NS-treated rats were all attenuated significantly by increasing the volume expansion with 11 mL/kg of HES administered immediately at the onset of heatstroke. Our data suggest that HES therapy seems superior to NS treatment during heatstroke. The benefit of HES therapy during heatstroke might have something to do with volume expansion rather than capillary permeability.

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“…Nevertheless, in theory, substitution of amylopectin molecules with hydroxyethyl groups might increase its immunogenic and antigenic potential [24], Earlier investigations with different modes of HES application (infusion or repeated i.m. administration of mg dosage) failed to induce immunization and formation of precipitating antibodies in man [24,26,27], In 8 patients with adverse reactions after HES infusion no precipitating antibodies could be detected by double immunodiffusion, a test with rela tively low sensitivity [25,28], There is only one study describing the exis tence of preformed HES-reactive antibodies in man. Normal subjects, who had never had any previous contact with HES.…”

Section: Discussionmentioning

confidence: 99%

“…The induction of specific antibodies against gelatine preparations was possible in rabbits and guinea pigs [19], However, a correlation between the occurrence of the gelatine-reac tive antibodies and anaphylactoid reaction was not shown, even in patients with de creased antigelatine antibody titres after gela tine infusion [20][21][22], Amylopectin -the main component of corn starch -is the basic substance for the synthesis of HES. Due to its structural simi larity with glycogen -an ubiquitous com pound in warm blooded organisms -immunogenicity of starch is expected to be unlikely [23][24][25]. Nevertheless, in theory, substitution of amylopectin molecules with hydroxyethyl groups might increase its immunogenic and antigenic potential [24], Earlier investigations with different modes of HES application (infusion or repeated i.m.…”

Section: Discussionmentioning

confidence: 99%

No Evidence for the Existence of Preformed Antibodies against Hydroxyethyl Starch in Man

et al. 1992

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Using the highly sensitive ELISA technique for detecting anti-hydroxyethyl starch (HES) antibodies in man sera from 1,056 patients were analyzed. Patients of both sex, who had never had any prior contact with HES, were included in the study. In none of the cases could any titer of HES-reactive antibodies be detected. These data suggest that in man preformed HES-reactive antibodies do not exist or are extremely rare. In any case, unlike dextran-reactive antibodies, they should not have a high clinical importance. The mechanism behind the very rarely observed anaphylactoid reactions after HES application is still unknown.

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Solutions and Emulsions Used for Intravenous Infusions

Cited by 8 publications

References 157 publications

CEREBROVASCULAR DYSFUNCTION IS AN ATTRACTIVE TARGET FOR THERAPY IN HEAT STROKE^¶

CEREBROVASCULAR DYSFUNCTION IS AN ATTRACTIVE TARGET FOR THERAPY IN HEAT STROKE^¶

Hydroxyethyl Starch Produces Attenuation of Circulatory Shock and Cerebral Ischemia During Heatstroke

No Evidence for the Existence of Preformed Antibodies against Hydroxyethyl Starch in Man

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Solutions and Emulsions Used for Intravenous Infusions

Cited by 8 publications

References 157 publications

CEREBROVASCULAR DYSFUNCTION IS AN ATTRACTIVE TARGET FOR THERAPY IN HEAT STROKE¶

CEREBROVASCULAR DYSFUNCTION IS AN ATTRACTIVE TARGET FOR THERAPY IN HEAT STROKE¶

Hydroxyethyl Starch Produces Attenuation of Circulatory Shock and Cerebral Ischemia During Heatstroke

No Evidence for the Existence of Preformed Antibodies against Hydroxyethyl Starch in Man

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Product

Resources

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CEREBROVASCULAR DYSFUNCTION IS AN ATTRACTIVE TARGET FOR THERAPY IN HEAT STROKE^¶

CEREBROVASCULAR DYSFUNCTION IS AN ATTRACTIVE TARGET FOR THERAPY IN HEAT STROKE^¶