Intravascular persistence of hydroxyethyl starch in man

Area of Science:

• Pharmacology
• Clinical Medicine

Background:

• Hydroxyethyl starch (HES) and dextran 60 are plasma volume expanders.
• Understanding their pharmacokinetic profiles and physiological effects is crucial for clinical use.

Purpose of the Study:

• To compare the elimination kinetics of HES and dextran 60 in healthy volunteers.
• To investigate the effect of HES infusion on serum alpha-amylase levels.

Main Methods:

• Two groups of five healthy volunteers received infusions of HES or dextran 60.
• Plasma levels of dextran 60 and HES were measured using the anthrone method and immunological techniques.
• Serum alpha-amylase was monitored post-infusion.

Main Results:

• Dextran 60 was undetectable after 4 weeks.
• HES exhibited prolonged intravascular persistence, with levels at 9% after 2 weeks and still above 1% after 17 weeks.
• HES infusion significantly augmented serum alpha-amylase concentrations.

Conclusions:

• HES demonstrates significantly longer persistence in circulation compared to dextran 60.
• The prolonged presence of HES raises concerns about potential tissue accumulation with repeated infusions.
• Elevated serum alpha-amylase following HES administration requires consideration during pancreatitis diagnosis.