The haemostatic effects of hydroxyethyl starch (HES) used as a volume expander

1985 ◽  
Vol 11 (6) ◽  
pp. 300-303 ◽  
Author(s):  
E. Macintyre ◽  
I. J. Mackie ◽  
D. Ho ◽  
J. Tinker ◽  
C. Bullen ◽  
...  
Keyword(s):  
Hydroxyethyl Starch ◽  
Volume Expander

Contribution of Raman spectroscopy in nephrology: a candidate technique to detect hydroxyethyl starch of third generation in osmotic renal lesions

The Analyst ◽  
2015 ◽  
Vol 140 (21) ◽  
pp. 7382-7390 ◽  
Author(s):  
V. Vuiblet ◽  
T. T. Nguyen ◽  
A. Wynckel ◽  
M. Fere ◽  
L. Van-Gulick ◽  
...  
Keyword(s):  
Raman Spectroscopy ◽  
Hydroxyethyl Starch ◽  
Hemodynamic Instability ◽  
Third Generation ◽  
Renal Lesions ◽  
Volume Expander

Raman spectroscopy, a candidate tool for detection of HES, a volume expander administrated after hemodynamic instability, in the kidney.

Characterization of Hydroxyethyl Starch by Polymer Analysis for Use as a Plasma Volume Expander

1993 ◽  
Vol 45 (12) ◽  
pp. 445-450 ◽  
Author(s):  
Werner-Michael Kulicke ◽  
Dierk Roessner ◽  
Wiebke Kull
Keyword(s):  
Hydroxyethyl Starch ◽  
Plasma Volume ◽  
Polymer Analysis ◽  
Plasma Volume Expander ◽  
Volume Expander

HES 200/0.5 Is not HES 200/0.5

1995 ◽  
Vol 74 (06) ◽  
pp. 1452-1456 ◽  
Author(s):  
Johannes Treib ◽  
Anton Haass ◽  
Gerhard Pindur ◽  
Ulrich T Seyfert ◽  
Wolfgang Treib ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Hydroxyethyl Starch ◽  
Clinical Relevance ◽  
Dilution Effect ◽  
Repeated Administration ◽  
Plasma Viscosity ◽  
Degree Of Substitution ◽  
Pronounced Increase ◽  
Large Molecules ◽  
Mean Molecular Weight

SummaryThe plasma clearance of hydroxyethyl starch (HES) depends on the initial molecular weight and the degree of substitution. So far, little attention has been paid to the clinical relevance of the C2/C6 substitution ratio of hydroxyethyl starch.10 patients with cerebrovascular circulatory disturbance received hemodilution therapy for 10 days, consisting of 10% HES 200/0.5 (mean molecular weight 200 kD, degree of substitution 0.5) with a C2/C6 ratio of 13.4. A second group of 10 patients received a starch solution with identical initial molecular weight and degree of substitution but with a C2/C6 ratio of 5.7.After the administration of a single dose, no significant differences between the two groups were observed. After repeated administration, significant differences could be detected in hemorheology, coagulation and elimination (p<0.01). The larger C2/C6 ratio led to a higher intravascular mean molecular weight (95 vs. 84 kD), which in turn led to a higher increase in serum concentration during the therapy (14.7 vs.8.6 mg/ml). Hematocrit was lowered more (-30,5 vs. -23,5%) and plasma viscosity was increased more. There was also a more pronounced increase in partial thromboplastin time (+30% vs. +13%) and a factor of 2 larger decrease of factor VIII/von Willebrand factor-complex (p <0.01), which exceeded the dilution effect.The higher C2/C6 ratio of HES 200/0.5/13.4 slows down enzymatic degradation. After repeated administration of this starch, large molecules accumulate which are inefficiently degraded. The same effect has been observed after therapy with highly-substituted HES. This accumulation of large molecules leads to a beneficial longer lasting volume effect. The disadvantages include an increase in plasma viscosity and coagulation disturbances, which cannot be explained with the respective dilution effect alone. For these reasons, the C2/C6 ratio is of clinical relevance and should be included in the product labeling in the future.

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