• J Koscielny, F Jung, C Mrowietz, G Pindur, H Förster, W Schimetta, H Kiesewetter, and E Wenzel.
• Abteilung für klinische Hämostaseologie und Transfusionsmedizin, Universitätskliniken des Saarlandes, Homburg/Saar.
• Infusionsther Transfusionsmed. 1994 Aug 1; 21 (4): 251-9.

ObjectiveInvestigation of the influence of C2/C6 occupation ratio of 2 different 6% hydroxyethyl starch (HES) solutions on elimination kinetics and blood fluidity.DesignA single-blinded, prospective randomised cross-over study.SettingHaemostasiological-angiologic outpatient department of the university of Homburg.Subjects6 voluntary apparently healthy subjects.InterventionsA 500 ml infusion of 2 different HES solutions (6% HES 200/0.5 or 6% HES 200/0.62, respectively) was given intravenously within 1 h. A wash-out phase of 3 months was kept between both infusions. The concentration and distribution of the molecular weight of the intravasal HES molecules up until 24 h after the infusion as well as the blood fluidity before and after the infusion were measured.ResultsBesides the molecular substitution (MS), which is different for the 2 employed HES solutions, the occupation ratio of the C2 respectively C6 (C2/C6 occupation ratio) of the glucose ring influences the breakdown of the HES molecules. This influences the blood fluidity. While the decrease in haematocrit 1 h after the end of the infusion is comparable, the decrease in the haematocrit in the case of high C2/C6 occupation ratio and a high MS is maintained for a longer period of time. The increase in plasma viscosity in the case of high C2/C6 occupation ratio and high MS is more marked.ConclusionsThe infusion of HES 200/0.62 leads to a significantly longer prevalence in comparison to HES 200/0.5, in combination with clearly larger degradation products in the plasma; this fact causes a more marked dilutional effect, but also a more marked increase in the plasma viscosity up to 24 h after the end of infusion. In the discussion on haemodilution therapy in patients with arterial occlusive disease the employment of HES which induces an increase in plasma viscosity is thought to be a disadvantage.

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