title: The effects of hydroxyethyl starches of varying molecular weights on platelet function.
abstract: We evaluated the effect of various hydroxyethyl starch (HES) solutions on platelet function. Blood was obtained before and after the IV infusion (10 mL/kg) of saline (n = 10), HES 70/0.5--0.55 (molecular weight in kD/degree of substitution; n = 10), HES 130/0.38--0.45 (n = 10), HES 200/0.6--0.66 (n = 10), or HES 450/0.7--0.8 (n = 10) in otherwise healthy patients scheduled for elective surgery. Collagen and epinephrine were used as agonists for assessment of platelet function analyzer closure times. Flow cytometry was used to assess agonist-induced expression of activated glycoprotein IIb/IIIa complex and P-selectin. Infusion of HES 450/0.7--0.8, HES 200/0.6--0.66, and HES 70/0.5--0.55 prolonged closure times and reduced glycoprotein IIb/IIIa expression, whereas saline and HES 130/0.38--0.45 had no significant effect on platelet variables. P selectin expression was not affected by any solution tested. In vitro experiments demonstrated a less inhibiting effect of HES 130/0.38--0.45 on closure times when compared with other HES solutions. This study shows that HES 450/0.7--0.8, HES 200/0.6--0.66, and HES 70/0.5--0.55 inhibit platelet function by reducing the availability of the functional receptor for fibrinogen on the platelet surface. Our data indicate that fluid resuscitation with HES 130/0.38--0.45 may reduce the risk of bleeding associated with synthetic colloids of higher molecular weight and degree of substitution.
authors.affiliation: Department of Anesthesiology and Intensive Care B, University of Vienna, School of Medicine, Vienna, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Franz
authors.forename: P
authors.initials: P
authors.lastname: Bräunlich
authors.forename: T
authors.initials: T
authors.lastname: Gamsjäger
authors.forename: M
authors.initials: M
authors.lastname: Felfernig
authors.forename: B
authors.initials: B
authors.lastname: Gustorff
authors.forename: S A
authors.initials: SA
authors.lastname: Kozek-Langenecker
mesh_terms: D000328:Adult; D001792:Blood Platelets / Q000187:drug effects*; D005434:Flow Cytometry; D006438:Hemodilution; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology*; D008297:Male; D008970:Molecular Weight; D010952:Plasma Substitutes / Q000494:pharmacology*; D010976:Platelet Count; D010979:Platelet Function Tests
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes