Journal
ANESTHESIA AND ANALGESIA
Volume 92, Issue 6, Pages 1402-1407Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/00000539-200106000-00008
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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 tit = 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.
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