title: Hypervolumetric hemodilution with HES 100/0.5 10% in patients with peripheral arterial occlusive disease (Fontaine, stage II): an open clinical and pharmacological phase IV study.
abstract: The efficacy of three weekly interventions with hypervolumetric hemodilution of a new preparation of hydroxyethyl starch (HES 100/0.5, 10%, C2/C6 substitution ratio of 6.5) on pain-free walking distance of patients with peripheral arterial occlusive disease (PAOD) stage IIb on the Fontaine classification was investigated. In addition quantitative data on the pharmacokinetic properties of this HES preparation, and it's impact on hemorheology, hemostasis and homeostasis were shown. Ten patients were included according to a predefined protocol, and treated openly with 500 ml HES 100/0.5 10% on nine occasions over 18 days. Pain-free walking distance, the main outcome measure, showed a mean increase of 82 m (+60%). Hematocrit decreased 4 percentage points on average (5.5 percentage points one hour after interventions). Plasma viscosity dropped 5% on average with significant changes immediately after interventions only in patients whose baseline values had been equal to or above the 2 s reference area. Erythrocyte aggregation decreased by 16% in the course of treatment (8% immediately after interventions), systolic blood pressure by 13%, and total protein by 7%. Complement showed a trend towards lower values (-20%), and creatinine, pH and urine viscosity remained unchanged. Apart from complement changes, all reductions mirrored the dilution effects. As to pharmacokinetics, serum mean molecular weight distribution was very similar to that of the infusion. A minor adverse drug reaction (light, spontaneously disappearing pruritus) was observed in one case.
authors.affiliation: Institute for Transfusion Medicine, University Clinic, Medical School of the Humboldt University, Berlin, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Koscielny
authors.forename: R
authors.initials: R
authors.lastname: Latza
authors.forename: A
authors.initials: A
authors.lastname: Pruss
authors.forename: H
authors.initials: H
authors.lastname: Kiesewetter
authors.forename: F
authors.initials: F
authors.lastname: Jung
authors.forename: C
authors.initials: C
authors.lastname: Meier
authors.forename: W
authors.initials: W
authors.lastname: Schimetta
mesh_terms: D000368:Aged; D000707:Anaphylaxis / Q000209:etiology; D001157:Arterial Occlusive Diseases / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D001809:Blood Viscosity / Q000187:drug effects; D015331:Cohort Studies; D004341:Drug Evaluation; D004342:Drug Hypersensitivity / Q000150:complications; D004903:Erythrocyte Aggregation / Q000187:drug effects; D005080:Exercise Test; D006400:Hematocrit; D006438:Hemodilution / Q000379:methods*; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D008875:Middle Aged; D008970:Molecular Weight; D010147:Pain Measurement; D016138:Walking
chemical_list: D006895:Hydroxyethyl Starch Derivatives