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Hydroxyethyl starch

S Jovtchev, S Alexandrov, N Hristova-Avakumova, S Miteva, L Traikov, D Gerasimova, S Stoeff
BACKGROUND: Different colloids are used as a part of solutions for fluid resuscitation and organ preservation: hydroxyethyl starches (HES), dextran (Dx), polyethylene glycols (PEG), polyvinyl pyrrolidone (PVP). Some of the problems associated with their application are addressed to alteration in erythrocyte (ERY) rheology. OBJECTIVE: We intended to estimate in vitro and compare the aggregation power (AP) of these molecules related to ERY interactions. METHODS: Washed human ERY are used during the study...
October 18, 2016: Clinical Hemorheology and Microcirculation
Andreas M Fichter, Lucas M Ritschl, Luisa K Robitzky, Stefan Wagenpfeil, David A Mitchell, Klaus-Dietrich Wolff, Thomas Mücke
The effects of antithrombotic drugs on random and free flap survival have been investigated in the past, but the experimental and clinical results are not in agreement. A perforator-based critical ischaemia model was used to evaluate the effects of different perioperatively administered pharmaceutical agents on tissue ischaemia and to assess the potential additional haemorheological or vasodilative effects of antithrombotics on flap microcirculation. Combined laser Doppler flowmetry and remission spectroscopy revealed an increase in certain microcirculation parameters in most groups in comparison with saline controls, and these changes correlated with flap survival...
October 21, 2016: Scientific Reports
Nicholas M Studer, Ahmad H Yassin, Donald E Keen
INTRODUCTION: The current Tactical Combat Casualty Care Guidelines recommend tranexamic acid (TXA) administration for casualties in whom massive blood transfusion is anticipated. However, despite Hextend being the recommended resuscitation fluid, the guidelines recommend against using TXA with Hextend. This appears to be due to a concern about pharmaceutical compatibility, despite the absence of a direct study of compatibility in the literature. METHODS: Two solutions of Hextend and TXA were examined for compatibility...
October 2016: Military Medicine
Robert Sümpelmann, Karin Becke, Sebastian Brenner, Christian Breschan, Christoph Eich, Claudia Höhne, Martin Jöhr, Franz-Josef Kretz, Gernot Marx, Lars Pape, Markus Schreiber, Jochen Strauss, Markus Weiss
This consensus- based S1 Guideline for perioperative infusion therapy in children is focused on safety and efficacy. The objective is to maintain or re-establish the child's normal physiological state (normovolemia, normal tissue perfusion, normal metabolic function, normal acid- base- electrolyte status). Therefore, the perioperative fasting times should be as short as possible to prevent patient discomfort, dehydration, and ketoacidosis. A physiologically composed balanced isotonic electrolyte solution (BS) with 1-2...
October 17, 2016: Paediatric Anaesthesia
Teemu Luostarinen, Ann-Christine Lindroos, T Niiya, M Silvasti-Lundell, Alexey Schramko, Juha Hernesniemi, Tarja Randell, Tomi Niemi
OBJECTIVE: Neurosurgery in general anesthesia exposes patient to hemodynamic alternations both in prone and sitting position. As the comparison of the sitting and prone position in neurosurgery is scarce, we aimed to evaluate hemodynamic profile during stroke volume-directed fluid administration in patients undergoing neurosurgery either in sitting or prone position. METHODS: Thirty patients in prone and 28 in sitting position in two separate prospective trials were randomized to receive either Ringer's Acetate (RAC) or hydroxyethyl starch (HES 130 kDa/0...
October 12, 2016: World Neurosurgery
Kambiz Masoumi, Arash Forouzan, Ali Asgari Darian, Alireza Rafaty Navaii
BACKGROUND: Appropriate fluid therapy affects morbidity and mortality rates. A conclusion is yet to be reached on the role of crystalloids and colloids in immediate fluid therapy. This study was done to determine the suitable solution in immediate resuscitation of patients with hemorrhagic shock caused by tissue trauma. METHODS: One hundred trauma patients with hemorrhagic shock, who underwent fluid therapy in the emergency unit, were assigned randomly to two groups of hydroxyethyl starch (Voluven) and normal saline...
November 2016: Journal of Clinical Medicine Research
Patrick Lauscher, Harry Kertscho, Malte Krömker, Barbara Haberichter, Kai Zacharowski, Peter Rosenberger, Jens Meier
BACKGROUND: Clonidine effectively decreases perioperative mortality by reducing sympathetic tone. However, application of clonidine might also restrict anaemia tolerance due to impairment of compensatory mechanisms. Therefore, the influence of clonidine induced, short-term sympathicolysis on anaemia tolerance was assessed in anaesthetized pigs. We measured the effect of clonidine on anaemia tolerance and of the potential for macrohemodynamic alterations to constrain the acute anaemia compensatory mechanisms...
October 12, 2016: BMC Anesthesiology
Stefanie U Frick, Matthias P Domogalla, Grit Baier, Frederik R Wurm, Volker Mailaender, Katharina Landfester, Kerstin Steinbrink
A major demand on immunotherapy is the direct interference with specific immune cells in vivo. In contrast to antibody-engineered nanoparticles to control dendritic cells function, targeting of T cells for biomedical applications still remains an obstacle as they disclose reduced endocytic activities. Here, by coupling the cytokine interleukin-2 (IL-2) to the surface of hydroxyethyl starch nanocapsules we demonstrated a direct and specifc T cell targeting in vitro and in vivo by IL-2 receptor mediated internalization...
October 10, 2016: ACS Nano
Michelle Griego-Valles, Yekaterina Buriko, Jennifer E Prittie, Philip R Fox
OBJECTIVE: To assess primary and secondary hemostasis following in vitro dilution of canine whole blood (WB) with hydroxyethyl starch (HES) 130/0.4 and HES 670/0.75. DESIGN: In vitro experimental study. SETTING: Private practice, teaching hospital. ANIMALS: Twenty-five healthy dogs. INTERVENTIONS: Each dog underwent venipuncture and 18 mL of venous blood was sampled once. MEASUREMENTS AND MAIN RESULTS: Collected blood was separated in 4 aliquots...
October 6, 2016: Journal of Veterinary Emergency and Critical Care
A Billal Sultani, Leah A Marquez-Curtis, Janet A W Elliott, Locksley E McGann
Cryopreservation of human umbilical vein endothelial cells (HUVECs) facilitated their commercial availability for use in vascular biology, tissue engineering and drug delivery research; however, the key variables in HUVEC cryopreservation have not been comprehensively studied. HUVECs are typically cryopreserved by cooling at 1 °C/min in the presence of 10% dimethyl sulfoxide (DMSO). We applied interrupted slow cooling (graded freezing) and interrupted rapid cooling with a hold time (two-step freezing) to identify where in the cooling process cryoinjury to HUVECs occurs...
October 6, 2016: Scientific Reports
Takeshi Umegaki, Takeo Uba, Chisato Sumi, Sachiyo Sakamoto, Sachiko Jomura, Kiichi Hirota, Koh Shingu
BACKGROUND: Previous studies reported a higher mortality risk and a greater need for renal replacement therapy in patients administered hydroxyethyl starch (HES) rather than other fluid resuscitation preparations. In this study, we investigated the association between 6% HES 70/0.5 use and postoperative acute kidney injury (AKI) in gastroenterological surgery patients. METHODS: We conducted retrospective full-cohort and propensity-score-based analyses of patients who underwent gastroenterological surgery between June 2011 and August 2013 in a Japanese university hospital...
October 2016: Korean Journal of Anesthesiology
Bulent Ergin, Philippe Guerci, Lara Zafrani, Frank Nocken, Asli Kandil, Ebru Gurel-Gurevin, Cihan Demirci-Tansel, Can Ince
BACKGROUND: Modulation of inflammation and oxidative stress appears to limit sepsis-induced damage in experimental models. The kidney is one of the most sensitive organs to injury during septic shock. In this study, we evaluated the effect of N-acetylcysteine (NAC) administration in conjunction with fluid resuscitation on renal oxygenation and function. We hypothesized that reducing inflammation would improve the microcirculatory oxygenation in the kidney and limit the onset of acute kidney injury (AKI)...
December 2016: Intensive Care Medicine Experimental
T K Kim, K Nam, Y J Cho, J J Min, Y J Hong, K U Park, D M Hong, Y Jeon
The infusion of fluids to patients may affect tissue microcirculation and the endothelial glycocalyx. However, the effects of hydroxyethyl starch and crystalloid on endothelial glycocalyx degradation and microvascular reactivity have not been evaluated in detail. We hypothesised that hydroxyethyl starch may cause less endothelial glycocalyx degradation and better microvascular reactivity than that caused by crystalloid. We randomly allocated 120 patients undergoing off-pump coronary artery bypass graft surgery to receive up to 20 ml...
September 26, 2016: Anaesthesia
K L Epstein, A Bergren, B Nie, R D Arnold, B M Brainard
A lower molecular weight and molar substitution formulation (130/0.4) of hydroxyethyl starch solution has been shown to have a more sustained effect on COP and similar hemodynamic effects as a higher molecular weight and molar substitution formulation (600/0.75) in healthy horses. In humans, these pharmacodynamic characteristics are coupled with more rapid clearance and decreased adverse coagulation effects and accumulation. The objective of this study was to determine and compare the pharmacokinetics of these two formulations in horses...
September 21, 2016: Journal of Veterinary Pharmacology and Therapeutics
Matthew James Lawrence, Nick Marsden, Jakub Kaczynski, Gareth Davies, Nia Davies, Karl Hawkins, Sounder Perumal, Martin Rowan Brown, Keith Morris, Simon J Davidson, Phylip Rhodri Williams, Phillip Adrian Evans
BACKGROUND: Balancing the beneficial effects of resuscitation fluids against their detrimental effect on hemostasis is an important clinical issue. We aim to compare the in vitro effects of 3 different colloid resuscitation fluids (4.5% albumin, hydroxyethyl starch [Voluven 6%], and gelatin [Geloplasma]) on clot microstructure formation using a novel viscoelastic technique, the gel point. This novel hemorheologic technique measures the biophysical properties of the clot and provides an assessment of clot microstructure from its viscoelastic properties...
September 15, 2016: Anesthesia and Analgesia
Brandi A Bottiger, Dmitri S Bezinover, Berend Mets, Priti G Dalal, Jansie Prozesky, Serdar Ural, Sonia Vaida
BACKGROUND AND AIMS: Patients undergoing elective cesarean delivery (CD) have a high-risk of spinal-induced hypotension (SIH). We hypothesized that a colloid preload would further reduce SIH when compared with a crystalloid preload. MATERIAL AND METHODS: Eighty-two healthy parturients undergoing elective CD were included in the study. Patients were randomly assigned to two groups (41 patients in each group) to receive either Lactated Ringer's solution (1500 ml) or hydroxyethyl starch (6% in normal saline, 500 ml) 30 min prior to placement of spinal anesthesia...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
T G V Cherpanath, B F Geerts, J J Maas, R B P de Wilde, A B Groeneveld, J R Jansen
BACKGROUND: Ventilator-induced dynamic hemodynamic parameters such as stroke volume variation (SVV) and pulse pressure variation (PPV) have been shown to predict fluid responsiveness in contrast to static hemodynamic parameters such as central venous pressure (CVP). We hypothesized that the ventilator-induced central venous pressure variation (CVPV) could predict fluid responsiveness. METHODS: Twenty-two elective cardiac surgery patients were studied post-operatively on the intensive care unit during mechanical ventilation with tidal volumes of 6-8 ml/kg without spontaneous breathing efforts or cardiac arrhythmia...
November 2016: Acta Anaesthesiologica Scandinavica
Shadan Li, Iren Constantinescu, Qiunong Guan, Manu T Kalathottukaren, Donald E Brooks, Christopher Y C Nguan, Jayachandran N Kizhakkedathu, Caigan Du
BACKGROUND: Efficient and effective perfusion during organ procurement is required for the best prevention of donor organ injury preceding transplantation. However, current organ preservation solutions, including hydroxyethyl starch (HES)-based University of Wisconsin (UW) solution, do not always yield the best outcomes. Our previous study demonstrated that replacing HES with hyperbranched polyglycerol (HPG) reduced donor heart injury during cold storage. The current research was designed to examine the advantages of HPG-based solution for cold kidney perfusion...
September 2016: Journal of Surgical Research
Vincent Vuiblet, Michael Fere, Ezechiel Bankole, Alain Wynckel, Cyril Gobinet, Philippe Birembaut, Olivier Piot, Philippe Rieu
In brain-dead donor resuscitation, hydroxyethyl starch (HES) use has been associated with presence of osmotic-nephrosis-like lesions in kidney transplant recipients. Our aim was to determine whether the presence of HES in protocol renal graft biopsies at three months (M3) after transplantation is associated with renal graft quality. According to the HES administered to the donor during the procurement procedure, two groups of patients were defined according graft exposition to HES: HES group, (N = 20) and control group (N = 6)...
2016: Scientific Reports
Monica B Pagano, Charles Harmon, Laura Cooling, Laura Connelly-Smith, Steven A Mann, Huy P Pham, Marisa B Marques, Annette J Schlueter, Rosemary Case, Karen E King, Guido Cataife, Yanyun Wu, Edward C C Wong, Jeffrey L Winters
BACKGROUND: Hydroxyethyl starch (HES) is reportedly associated with an increased risk of renal failure and death when used for fluid resuscitation in critically ill patients. HES can be used during therapeutic leukocytapheresis (TL) procedures to enhance cell separation. The purpose of this study was to evaluate the occurrence of adverse events associated with HES during TL procedures. STUDY DESIGN AND METHODS: We performed a retrospective review of patients who underwent TL with and without HES in the period 2009 to 2013 at six academic medical institutions...
September 7, 2016: Transfusion
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