In vitro effects of three formulations of hydroxyethyl starch solutions on coagulation and platelet function in horses

Blong, April E.; Epstein, Kira L.; Brainard, Benjamin M.

doi:10.2460/ajvr.74.5.712

Cited by 26 publications

(48 citation statements)

References 36 publications

(51 reference statements)

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“…The decrease in vWF and fVIII activities as a result of HES administration is a phenomenon that has been reported in many human25 and some veterinary3, 14 studies, and likely contributes to the impaired ability of the platelets to aggregate, especially under conditions of high shear. The most frequently cited hypothesis for the drop in these factors is that the HES molecules bind to the vWF/fVIII complex and speed excretion from circulation.…”

Section: Discussionmentioning

confidence: 81%

“…The instrument used for this study was chosen over thromboelastography because more significant changes were found during previous in vitro testing in horses 14. Coagulation effects were not as prominent using viscoelastic testing as previous in vitro work in horses14 and humans 18, 27.…”

Section: Discussionmentioning

confidence: 99%

“…Whole blood coagulation analysis was performed using a viscoelastic coagulation monitor,21 using previously described techniques 14, 22, 23. Briefly, samples were rested for 30 minutes at room temperature.…”

Section: Methodsmentioning

confidence: 99%

“…In vitro comparison of this product to higher molecular weight and molar substitution HES (6% HES 600 kD/0.75 and 670 kD/0.75) (hetastarches) suggests that there is less impairment of coagulation by the low molecular weight and low molar substitution formulation 14. This study was designed to compare the effects of a low and high molecular weight and molar substitution formulation of HES solution on cardiovascular variables, colloid osmotic pressure (COP), and hemostasis in normal horses.…”

mentioning

confidence: 90%

“…Effects are dose dependent and limit the maximum recommended dose of these products 5. Coagulation impairments associated with administration of HES solution have been evaluated in humans,5, 8, 9 dogs,10, 11 and horses 3, 12, 13, 14…”

mentioning

confidence: 99%

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Cardiovascular, Colloid Osmotic Pressure, and Hemostatic Effects of 2 Formulations of Hydroxyethyl Starch in Healthy Horses

Epstein

Bergren

Giguère

et al. 2013

Veterinary Internal Medicne

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BackgroundLower molecular weight and molar substitution formulations of hydroxyethyl starch (HES) solutions might maximize cardiovascular function and colloid osmotic pressure (COP) and minimize adverse effects on coagulation.Hypothesis/ObjectivesTo compare effects of 1 low and 1 high molecular weight and molar substitution HES solution on cardiovascular variables, COP, and hemostasis in normal horses.AnimalsEight healthy adult horses.MethodsRandomized, crossover designed study: 10 mL/kg bolus of 6% HES (600/0.75) (hetastarch) (HS), 6% HES (130/0.4) tetrastarch (TS), and 0.9% NaCl (NS). Variables recorded included central venous pressure (CVP), noninvasive arterial blood pressure, packed cell volume (PCV), COP, and automated platelet analysis (CT).ResultsCentral venous pressure was increased for 8 hours after all treatment (baseline = 8.4 ± 3.8; 8 hours = 10.3 ± 3.5 cm H2O; P < .001). HS and TS produced an increase in systolic arterial pressure (HS = 109.1 ± 11.9; TS = 109.5 ± 10.9 mmHg) and mean arterial pressure (HS = 80.4 ± 13.0; TS = 82.3 ± 10.1 mmHg) compared to NS (SAP = 103.2 ± 13.2 [P = .023]; MAP = 74.2 ± 11.4 mmHg [P = .048]). PCV decreased transiently with HS (baseline = 37.1 ± 4.4%; 1.5 hours = 31.6 ± 3.9%) and TS (baseline = 38.4 ± 3.9%; 1.5 hours = 32.2 ± 3.3%), but not NS (P = .007). COP was greater with HS (1 hour; 24.0 ± 2.1 mmHg) and TS (8 hours; 25.9 ± 2.1 mmHg) than NS (1 hour = 20.8 ± 2.6; 8 hours = 22.9 ± 3.1 mmHg; P < .001). CT was greater at 8 (HS = 178.6 ± 36.9; TS = 121.9 ± 33.3; NS = 108.3 ± 23.6 seconds) and 24 hours (HS = 174.2 ± 41.7; TS = 100.8 ± 26.0; NS = 118.7 ± 38.7 seconds; P < .001) in horses receiving HS than TS or NS.Conclusion and Clinical ImportanceBoth TS and HS resulted in more effective volume expansion and arterial pressure support than NS. TS produced a more sustained effect on COP with shorter duration of adverse effects on platelet function than HS.

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Section: Discussionmentioning

confidence: 81%