Coagulation effects of a recently developed hydroxyethyl starch (HES 130/0.4) compared to hydroxyethyl starches with higher molecular weight.
BACKGROUND
Hydroxyethyl starches (HES) are known to interfere with blood coagulation according to molecular weight, the degree of substitution and the C2/C6 ratio. A recently developed low molecular hydroxyethyl starch (HES 130/0.4) was designed to reduce the blood compromising potency.


METHODS
In this study, effects of a 30% in vitro haemodilution with the new HES preparation (HES 130/0.4) in comparison to HES 200/0.5, HES 450/0.7 and sodium chloride solution were investigated using intrinsic and extrinsic activated thrombelastography (TEG) and plasmatic coagulation tests.


RESULTS
Whereas plasmatic tests revealed no prolongation of coagulation by HES in comparison to sodium chloride, the TEG variables clotting time, clot formation time and maximal clot firmness showed a significant (P<0.05) inhibition by all the HES preparations. The inhibition was most pronounced in HES 450 (P<0.05 vs HES 130) while HES 130 did not show a statistically significant difference in extrinsic activated maximal clot firmness when compared to sodium chloride.


CONCLUSIONS
These in vitro results demonstrate that hydroxythyl starches especially compromise clot polymerisation. The new preparation HES 130/0.4 seems to inhibit platelet function to a lesser extent than hydroxyethyl starch preparations with a higher molecular weight and degree of substitution.
Entholzner
E K
EK
Arbeitsgruppe Hämostaseologie, Technische Universität München, Klinikum rechts der Isar, Germany.
Mielke
L L
LL
Calatzis
A N
AN
Feyh
J
J
Hipp
R
R
Hargasser
S R
SR
D001777:Blood Coagulation / Q000187:drug effects*; D001780:Blood Coagulation Tests; D006438:Hemodilution; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000737:chemistry / Q000494:pharmacology*; D066298:In Vitro Techniques; D008970:Molecular Weight; D010314:Partial Thromboplastin Time; D010952:Plasma Substitutes / Q000737:chemistry / Q000494:pharmacology*; D011517:Prothrombin Time; D012965:Sodium Chloride; D013916:Thrombelastography
D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D012965:Sodium Chloride