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Related Experiment Videos

[Hydroxethyl starch: effects on hemostasis]

J Treib1, J F Baron

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

Annales Francaises D'Anesthesie Et De Reanimation
|September 29, 1998
PubMed
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Hydroxyethyl starches (HES) with low in vivo molecular weight (Mw) minimize bleeding risks and improve rheological effects. Future characterization should prioritize in vivo Mw over in vitro Mw for clinical relevance.

Area of Science:

  • Biochemistry
  • Pharmacology
  • Biomaterials

Context:

  • Hydroxyethyl starches (HES) are glucose-based polymers derived from maize amylopectin.
  • Initial characterization focused on in vitro molecular weight (Mw), neglecting in vivo hydrolysis by alpha-amylase.
  • Hydroxyethylation is quantified by the degree of substitution and molar substitution ratio, influencing glucose unit substitution patterns (C2/C6 ratio).

Purpose:

  • To highlight the clinical relevance of in vivo Mw for HES administration.
  • To explain how in vitro Mw, degree of substitution, and C2/C6 ratio determine in vivo Mw.
  • To advocate for in vivo Mw as the primary characteristic for HES evaluation.

Summary:

  • In vivo Mw is determined by in vitro Mw, degree of substitution, and C2/C6 ratio.

Related Experiment Videos

  • Low in vivo Mw HES reduces hemorrhagic complications by preserving coagulation and platelet function.
  • Low in vivo Mw HES offers improved rheological properties and a shorter half-life, benefiting patients with bleeding risks or affected reticuloendothelial systems (RES).

    • Impact:

    • Low in vivo Mw HES prevents acquired type I von Willebrand syndrome and minimizes platelet volume reduction.
    • High Mw HES negatively impacts plasma viscosity and can saturate the RES, indicated by decreased fibronectin.
    • HES with low in vivo Mw are recommended for patients with bleeding risks, microcirculatory disturbances, or compromised RES.