[Changes in blood coagulation in treatment with hydroxyethyl starch].

Abstract

The aim of the study was to investigate the influence on coagulation and platelet function of two 6% medium molecular weight hydroxyethylstarch solutions (HES, MW 200,000, DS 0.5) made of potato (K) and corn (M) starch. Twenty patients undergoing elective vertebral disc surgery were randomly assigned to one of the groups. Haemoglobin, haematocrit, protein concentration, fibrinogen, antithrombin III, factor VIII:C, von-Willebrand-factor, prothrombin time, activated partial thromboplastin time and platelet maximum aggregation and maximum gradient of aggregation (inductors: ADP, epinephrine, collagen and ristocetin) were measured before infusion and 30, 240 minutes and one day after infusion. The reduction of the prothrombin time (Quick) and antithrombin III and the decrease in fibrinogen and protein concentration, haemoglobin and haematocrit were due to haemodilution. The prolongation of the activated partial thromboplastin time (38.3 s K-group and 38.0 s M-group) and the decrease in factor VIII:C (71% K-group and 84% M-group) and von-Willebrand-factor (72% K group and 79% M group) were similar in both groups within 30 minutes of infusion of 1,000 ml HES. There was no change in platelet function within the groups. The infusion of a medium molecular weight solution is an effective and cost-saving method in volume therapy. Despite the physicochemical differences of the two HES solutions, there were no clinically apparent effects on coagulation and platelet function. Both preparations of HES up to a volume of 1,000 ml can be used equally in the clinical setting.