title: Interactions between the volume effects of hydroxyethyl starch 130/0.4 and Ringer´s acetate.
abstract: BACKGROUND
  The turnover of Ringer´s solutions is greatly dependent on the physiological situation, such as the presence of dehydration or anaesthesia. The present study evaluates whether the kinetics is affected by previous infusion of colloid fluid.
  
  
  METHODS
  Ten male volunteers with a mean age of 22 years underwent three infusion experiments, on separate days and in random order. The experiments included 10 mL/kg of 6% hydroxyethyl starch 130/0.4 (Voluven™), 20 mL/kg of Ringer's acetate, and a combination of both, where Ringer´s was administered 75 minutes after the starch infusion ended. The kinetics of the volume expansion was analysed by non-linear least- squares regression, based on urinary excretion and serial measurement of blood haemoglobin concentration for up to 420 minutes.
  
  
  RESULTS
  The mean volume of distribution of the starch was 3.12 L which agreed well with the plasma volume (3.14 L) estimated by anthropometry. The volume expansion following the infusion of starch showed monoexponential elimination kinetics with a half-life of two hours. Two interaction effects were found when Ringer´s acetate was infused after the starch. First, there was a higher tendency for Ringer´s acetate to distribute to a peripheral compartment at the expense of the plasma volume expansion. The translocated amount of Ringer´s was 70% higher when HES had been infused earlier. Second, the elimination half-life of Ringer´s acetate was five times longer when administered after the starch (88 versus 497 minutes, P<0.02).
  
  
  CONCLUSIONS
  Starch promoted peripheral accumulation of the later infused Ringer´s acetate solution and markedly prolonged the elimination half-life.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT01195025.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Hahn
authors.forename: Christian
authors.initials: C
authors.lastname: Bergek
authors.forename: Tobias
authors.initials: T
authors.lastname: Gebäck
authors.forename: Joachim
authors.initials: J
authors.lastname: Zdolsek
mesh_terms: D000293:Adolescent; D000328:Adult; D001810:Blood Volume / Q000187:drug effects / Q000502:physiology*; D004347:Drug Interactions / Q000502:physiology; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage / Q000097:blood*; D007262:Infusions, Intravenous; D007552:Isotonic Solutions / Q000008:administration & dosage / Q000378:metabolism*; D008297:Male; D010952:Plasma Substitutes / Q000008:administration & dosage / Q000378:metabolism*; D055815:Young Adult
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes; C028570:Ringer's acetate