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[Decrease of thrombocyte volume after several days infusion of highly substituted medium molecular weight

J Treib1, A Haass, G Pindur

  • 1Neurologische Klinik, Universitätskliniken des Saarlandes, Homburg, Bundesrepublik Deutschland.

Wiener Klinische Wochenschrift
|January 1, 1996
PubMed
Summary

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Long-term hydroxyethyl starch (HES) therapy affects platelet function. Higher concentration HES significantly reduced platelet volume and aggregation, while lower concentration HES did not impact aggregation.

Area of Science:

  • Pharmacology
  • Hematology
  • Critical Care Medicine

Background:

  • Dextrans are known platelet aggregation inhibitors.
  • Hydroxyethyl starch (HES) effects on platelet aggregation are conflicting, especially with single-dose administration.

Purpose of the Study:

  • To investigate the effects of long-term hemodilution therapy using different concentrations of hydroxyethyl starch (HES) on platelet number, aggregation, and volume.
  • To clarify the impact of HES on platelet parameters during extended therapeutic interventions.

Main Methods:

  • Randomized study of 12 patients with cerebrovascular perfusion disturbances, divided into two groups (6 patients each).
  • Group 1 received 10% HES 200/0.62; Group 2 received 6% HES 200/0.62.
  • Both groups received a loading dose, followed by daily infusions for 10 days with varying daily volumes for Group 2.

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Main Results:

  • 10% HES demonstrated a greater volume effect, lowering hematocrit by 19.0% compared to 15.6% with 6% HES.
  • 10% HES significantly reduced platelet number (5.8%) and platelet volume (13.9%), while 6% HES did not significantly alter platelet number.
  • Platelet volume significantly decreased in both groups, likely due to colloid-osmotic shrinkage; 10% HES therapy showed a slight but significant decline in platelet aggregation.

Conclusions:

  • During long-term hemodilution with HES, initial dilution-induced platelet number decrease is compensated.
  • Continuous decline in mean platelet volume is likely due to colloid-osmotic shrinkage.
  • The observed slight inhibition of platelet aggregation with 10% HES correlates with reduced platelet size, suggesting a link between platelet volume and function.