Titre
Novel starches: single-dose pharmacokinetics and effects on blood coagulation.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Madjdpour, C.
Auteure/Auteur
Thyes, C.
Auteure/Auteur
Buclin, T.
Auteure/Auteur
Frascarolo, P.
Auteure/Auteur
von Roten, I.
Auteure/Auteur
Fisch, A.
Auteure/Auteur
Burmeister, M.
Auteure/Auteur
Bombeli, T.
Auteure/Auteur
Spahn, D.R.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
0003-3022
Statut éditorial
Publié
Date de publication
2007
Volume
106
Numéro
1
Première page
132
Dernière page/numéro d’article
143
Peer-reviewed
Oui
Langue
anglais
Notes
Journal Article Research Support, Non-U.S. Gov't --- Old month value: Jan
Résumé
BACKGROUND: Carboxymethyl starch (CMS) and carboxymethylated hydroxyethyl starch (CM-HES) might offer advantages over hydroxyethyl starch (HES) with regard to their volume expansion effect and their pharmacokinetic characteristics. The goal of the current study was to determine the pharmacokinetics of CMS and CM-HES and to investigate their influence on blood coagulation in comparison with the standard low-molecular, low-substituted HES (130/0.42) used in Europe. METHODS: The study was conducted as a randomized, blinded, parallel three-group study in 30 pigs. Twenty ml/kg of 6% HES (control), 6% CMS, or 6% CM-HES was infused as a single dose, and serial blood sampling was performed over 20 h to measure plasma concentration and molecular weight and to assess blood coagulation. Concentration-effect relations were assessed by pharmacokinetic-pharmacodynamic analysis. RESULTS: CMS and CM-HES showed significantly higher plasma concentrations and molecular weights over 20 h (P for both<0.001) with smaller volumes of distribution and longer elimination rates during the terminal phase (P for both<0.01) when compared with HES. CMS and CM-HES impaired whole blood coagulation more than HES as assessed by Thrombelastograph analysis (Haemoscope Corporation, Niles, IL). However, similar effects of all three starch preparations on blood coagulation were found when related to the plasma concentrations in mass units. CONCLUSIONS: Carboxymethylation of starch results in an increased intravascular persistence and a slower fragmentation compared with HES. The greater impairment of blood coagulation by CMS and CM-HES seems to be caused by the higher plasma concentrations.
PID Serval
serval:BIB_A94B5F296DA1
PMID
Date de création
2008-01-25T09:46:14.651Z
Date de création dans IRIS
2025-05-21T03:20:38Z