Decreased circulating levels of von Willebrand factor after intravenous administration of a rapidly degradable hydroxyethyl starch (HES 200/0.5/6) in healthy human subjects.
OBJECTIVE
Impairment of haemostasis has been described with slowly degradable medium molecular weight hydroxyethyl starch (MMW-HES), whereas rapidly degradable MMW-HES is generally considered to have no important effects on blood coagulation. This study was undertaken to investigate the effects of a rapidly degradable MMW-HES plasma substitute on primary haemostasis and blood coagulation in human subjects.


METHODS
Randomised, cross-over study.


METHODS
Research unit of a university hospital.


METHODS
Nine healthy, adult male volunteers.


METHODS
A 60-min intravenous infusion of 1 l HES 200/0.5/6 (HAES-steril 6%) or 4% albumin (control).


RESULTS
The infusion of HES resulted in decreased circulating levels of von Willebrand factor antigen (from 85+/-8% to 59+/-6% after HES vs from 80+/-7% to 69+/-8% after albumin, p<0.05) and ristocetin cofactor activity (from 93+/-4 to 67+/-4% after HES vs from 79+/-5 to 75+/-5% after albumin, p<0.01). This was associated with an impairment of in vitro platelet function as determined with the PFA-100 platelet function analyser (closure time with collagen/epinephrine from 120+/-7 to 159+/-14 s after HES vs from 121+/-7 to 137+/-10 s after albumin, p<0.05; with collagen/ADP from 88+/-3 to 116+/-9 s and from 103+/-4 to 114+/-7 s after HES and albumin, respectively, p=0.01).


CONCLUSIONS
The infusion of 1 l of HES 200/0.5/6 in healthy human subjects results in moderately decreased plasma levels of von Willebrand factor associated with impairment of platelet function.
de Jonge
E
E
Department of Intensive Care, Academic Medical Centre, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands. e.dejonge@amc.uva.nl
Levi
M
M
Büller
H R
HR
Berends
F
F
Kesecioglu
J
J
D000328:Adult; D000704:Analysis of Variance; D018592:Cross-Over Studies; D006487:Hemostasis; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D008297:Male; D010952:Plasma Substitutes / Q000008:administration & dosage*; D010979:Platelet Function Tests; D014841:von Willebrand Factor / Q000032:analysis*
D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D014841:von Willebrand Factor