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[Acetyl starch as volume substitute, a possible alternative to HES]
F Asskali1, U Warnken, H Förster
1Institut für Experimentelle Anästhesiologie, Johann Wolfgang Goethe-Universität, Frankfurt. asskali@em.uni-frankfurt.de
Deutsche Medizinische Wochenschrift (1946)
|February 24, 2001
Summary
Acetyl starch (ACS) did not accumulate in serum during repeated infusions, unlike hydroxyethyl starch (HES). ACS is a well-tolerated alternative for volume replacement, though its stability requires cold storage.
Area of Science:
- Pharmacology
- Biochemistry
Background:
- Hydroxyethyl starch (HES) is a commonly used plasma volume expander.
- Concerns exist regarding HES accumulation and associated side effects.
Purpose of the Study:
- To compare the pharmacokinetics and tolerability of acetyl starch (ACS) versus HES.
- To evaluate ACS as a potential alternative to HES for intravenous fluid replacement.
Main Methods:
- Repeated intravenous infusions of 500 ml ACS (n=8) or HES (n=9) over five consecutive days in male volunteers.
- Pharmacokinetic parameters (Cmax, AUC0-24, t1/2), acid-base status, coagulation, acetic acid, and blood glucose levels were monitored.
Main Results:
- HES demonstrated accumulation in serum, indicated by increasing pharmacokinetic parameters.
- ACS showed no accumulation, with stable pharmacokinetic parameters throughout the study.
- ACS infusions were well-tolerated, with no significant impact on acid-base or blood glucose levels.
- ACS's effect on coagulation was comparable to HES, attributed to dilution.
Conclusions:
- Acetyl starch (ACS) is a viable alternative to HES for volume replacement.
- ACS may avoid side effects associated with HES tissue storage.
- Limited room temperature stability restricts ACS usage; cold storage is required.