Advantages of a narrow-range, medium molecular weight hydroxyethyl starch for volume maintenance in a porcine model of fecal peritonitis

The effect of hydroxyethyl starch and other plasma volume substitutes on endothelial cell activation; an in vitro study

“…One of us has shown previously, in a porcine model of faecal peritonitis, that animals resuscitated with a diafiltered pentastarch of medium molecular weight showed less evidence of capillary leak and decreased accumulation of neutrophils in the pulmonary capillary and hepatic sinusoids compared to animals treated with undiafiltered hydroxyethyl starches [12,13]. We hypothesised that these findings were related to suppression of neutrophil adhesion to the endothelium, perhaps related to the higher concentration of medium molecular weight fractions in the diafiltered pentastarch (MWw 120000 dalton, MW n 280000 dalton).…”

RETRACTED ARTICLE: Volume therapy in the intensive care patient – we are still confused, but...

“…However, ªall colloids are not created equalº [84]. Whether all colloids are contraindicated in patients with capillary leak, or whether some colloids may even avoid further leakage (ªplugging the leakº) has been extensively discussed [85,86]. There is experimental and clinical evidence that starch preparations with a narrow-range MMW (200±250 kDa) are more effective in avoiding or reducing capillary permeability oedema than other preparations [87,88].…”

Assessment of hemodynamic and gastric mucosal acidosis with modified fluid gelatin versus 6% hydroxyethyl starch: a prospective, randomized study

“…Mean values SD values. *p = 0.0006 between T0 and T1 in MFG group; # p < 0.02 between the two groups at T1 ficient in maintaining capillary patency and alveolar capillary barrier thickness than hetastarch (400,000/0.7) in a porcine model of fecal peritonitis [28]. This theoretical advantage of starches was confirmed in studies involving septic and trauma patients, which demonstrated an improvement of endothelial associated-coagulation [29,30] and an improvement of gastric mucosal acidosis and liver function with 10 % HES solution (mean weight 200,000 daltons, degree of substitution 0.5) [31].…”