title: Coagulation, oncotic and haemodilutional effects of a third-generation hydroxyethyl starch (130/0.4) solution in horses.
abstract: BACKGROUND
  Clinical indications for hydroxyethyl starches (HES) in horses include rapid plasma volume expansion and oncotic support during periods of hypoproteinaemia. Side effects such as coagulopathies associated with HES administration pose limitations to their use in veterinary medicine. In man, tetrastarch (130/0.4) has demonstrated less profound effects on coagulation compared with first- and second-generation HES.
  
  
  OBJECTIVE
  To evaluate the haemostatic and oncotic effects of tetrastarch (130/0.4) administered at 10, 20 and 40 ml/kg bwt in healthy horses.
  
  
  METHODS
  Randomised crossover experiment.
  
  
  METHODS
  Tetrastarch (130/0.4) was administered to 6 healthy pony mares at 10, 20 and 40 ml/kg bwt with a 2-week washout period. Packed cell volume, plasma total solids, colloid osmotic pressure (COP), platelet count and thromboelastography (TEG) were measured at baseline, immediately after infusion (0 h), and 1, 6, 12, 24, 48 and 96 h after tetrastarch infusion.
  
  
  RESULTS
  All TEG variables remained within normal reference ranges in all 3 treatment groups. Administration of tetrastarch at 40 ml/kg bwt resulted in a prolonged K-time (P = 0.049) at 6 h post infusion, and decreased maximum amplitude at 0 (P<0.001), 1 (P = 0.022), 6 (P = 0.006), 24 (P<0.001) and 48 h (P = 0.013) post infusion compared with baseline. Administration of tetrastarch increased mean COP values above baseline in all 3 treatment groups, persisting to 24, 6 and 48 h for the 10, 20 and 40 ml/kg bwt doses, respectively.
  
  
  CONCLUSIONS
  Although still within established reference ranges, compared with lower dosages, the administration of 40 ml/kg bwt tetrastarch (130/0.4) is more likely to induce changes in coagulation as measured by TEG. Tetrastarch increased COP at all dosages evaluated in healthy horses. Tetrastarch (130/0.4) at 10 and 20 ml/kg bwt has potential as a synthetic colloid for resuscitation and provision of oncotic support in horses.
authors.affiliation: Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa.
authors.forename: A
authors.initials: A
authors.lastname: Viljoen
authors.forename: P C
authors.initials: PC
authors.lastname: Page
authors.forename: G T
authors.initials: GT
authors.lastname: Fosgate
authors.forename: M N
authors.initials: MN
authors.lastname: Saulez
mesh_terms: D000818:Animals; D001647:Bile Acids and Salts / Q000097:blood; D001777:Blood Coagulation / Q000187:drug effects*; D003404:Creatinine / Q000097:blood; D018592:Cross-Over Studies; D005260:Female; D006400:Hematocrit / Q000662:veterinary; D006487:Hemostasis; D006736:Horses / Q000097:blood*; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage / Q000494:pharmacology*; D009997:Osmotic Pressure; D010949:Plasma / Q000737:chemistry; D010952:Plasma Substitutes / Q000008:administration & dosage / Q000494:pharmacology*; D010976:Platelet Count / Q000662:veterinary
chemical_list: D001647:Bile Acids and Salts; D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D003404:Creatinine
keywords: horse; hydroxyethyl starch; oncotic pressure; tetrastarch; thromboelastography