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[Changes in blood coagulation in treatment with hydroxyethyl starch]
P Sefrin1, S Rauch, C Zieglmeyer
1Klinik für Anästhesiologie, Universität Würzburg.
Anaesthesiologie Und Reanimation
|February 26, 1999
Summary
Two hydroxyethylstarch (HES) solutions derived from potato and corn starch showed no significant differences in their effects on patient coagulation and platelet function during surgery. Both HES preparations are equally safe and effective for volume therapy.
Area of Science:
- Anesthesiology
- Pharmacology
- Hematology
Background:
- Hydroxyethylstarch (HES) solutions are widely used for volume replacement therapy.
- Medium molecular weight HES solutions (MW 200,000, DS 0.5) derived from different starch sources may have varying effects on hemostasis.
- Investigating these effects is crucial for ensuring patient safety and optimizing therapeutic strategies.
Purpose of the Study:
- To compare the influence of two medium molecular weight HES solutions (potato-derived K and corn-derived M) on coagulation and platelet function.
- To assess the clinical efficacy and safety of these HES preparations in patients undergoing elective vertebral disc surgery.
Main Methods:
- A randomized study involving 20 patients undergoing elective vertebral disc surgery.
- Administration of 1,000 ml of either potato-derived (K) or corn-derived (M) HES solution.
- Comprehensive analysis of coagulation parameters (hemoglobin, hematocrit, protein, fibrinogen, antithrombin III, factor VIII:C, von-Willebrand-factor, prothrombin time, activated partial thromboplastin time) and platelet function (aggregation and gradient) at various time points pre- and post-infusion.
Main Results:
- Hemodilution accounted for reductions in prothrombin time, antithrombin III, fibrinogen, protein concentration, hemoglobin, and hematocrit.
- A similar, mild prolongation of activated partial thromboplastin time and decrease in factor VIII:C and von-Willebrand-factor were observed in both groups within 30 minutes post-infusion.
- No significant alterations in platelet function were detected in either group throughout the study period.
Conclusions:
- Both potato-derived and corn-derived medium molecular weight HES solutions (1,000 ml) demonstrate comparable safety and efficacy in terms of coagulation and platelet function.
- These HES preparations are effective and cost-efficient options for volume therapy in surgical settings.
- Physicochemical differences between the two HES solutions did not translate into clinically significant variations in hemostatic effects.