The pentafraction of hydroxyethyl starch inhibits ischemia-induced compartment syndrome

Pentafraction (PF), a solution of biodegradable hydroxyethyl starch macromolecules with molecular weights of 10 to 100 x 10(4) daltons, has been shown to minimize tissue edema by sealing interendothelial clefts at the capillary level. The effect of PF on ischemia-reperfusion-induced compartment syndrome was studied. Ten rabbits underwent bilateral femoral artery occlusion following ligation of branches from the terminal aorta to the popliteal artery. After 7 hours of ischemia, reperfusion was established with heparinized polyethylene shunts. Experimental animals (n = 5) received PF and control animals (n = 5) received normal saline (NS) as an intravenous infusion (30 mL/kg) for 1 hour, beginning 10 minutes after shunt placement. During reperfusion, anterior compartment pressure was continuously monitored in the left lower extremity. To quantitate oxidative metabolism, triphenyltetrazolium chloride (TTC) reduction (micrograms of TTC per milligram of protein) of tibialis anterior muscle from the right lower extremity was measured at femoral artery occlusion, 7 hours of ischemia, and 2 hours of reperfusion. In the NS group, anterior compartment pressure significantly increased from the end of the ischemic interval, 10.8 +/- 4.14 to 36.4 +/- 9.9 mmHg and 44.6 +/- 15.4 mmHg, after 1 and 2 hours of reperfusion (p < 0.007) compared with the PF group, which did not change significantly, 10.6 +/- 2.6 to 11.4 +/- 12.9 mmHg and 7.4 +/- 2.8 mmHg, after 1 and 2 hours of reperfusion (p < 0.67).(ABSTRACT TRUNCATED AT 250 WORDS)