The Degree of Vascular Leak of Hydroxyethyl Starch in Severe Hemorrhagic Shock in Rats

Takashi Hitosugi, Toshiyuki Saito and Yoshiyuki Oi

Department of Dental Anesthesiology, Kyushu University, Japan
Department of Anesthesiology, Nihon University Graduate School of Dentistry, Japan

^*Correspondance to: Takashi Hitosugi 

 PDF  Full Text DOI: 10.25107/2474-1647.2021

Abstract

Aim of the Study: In circulatory shock, colloid solution is beneficial to effectively maintain blood pressure. The HES solution is characterized by its mean Molecular Weight (MW), concentration, Degree of Substitution (DS) and the pattern of the substitution (C2/C6). To find the ideal character of the HES to administer to the patients in shock, we studied how the HES is retained in the vascular vessels in the shock rats using three types of HES bound with Fluorescein-Isothiocyanate (FITCHES) with a spectrophotometer-computer detection system to determine the rate of elution of the HES from the microvascules.Methods: We adopted the model of a severe hemorrhagic shock with a Mean Arterial Pressure (MAP) of 50 mmHg in rats. We infused one of three types of FITC-HES; HES-A (MW 150-200 kDa, DS: 0.6-0.68, C2/C6=8), HES-B (MW 175 kDa to 225 kDa, DS: 0.45 to 0.55, C2/C6=6) or HES-C (MW 550 kDa to 850 kDa, DS: 0.7 to 0.8, C2/C6=5). The FITC-HES retention rates in the image of the intravital microscope.Results: MAP transiently increased toward the baseline value after infusion but then progressively decreased in all groups. HES-C remained in the A2 arteriole longer than HES-A (P=0.022). HES-C was eluted from the blood vessels more slowly than HES-A (P=0.028). We did not find any statistical difference in MAP among groups and the rate of disappearance from the vessels between HES-A, HES-B and HES-C.Conclusion: HES of high MW was retained in the blood vessel longer those HES with low MW. In the hypovolemia, the retention rate was more dependent to the MW than that in the normovolemia. Other factors as DS and C2/C6 showed less effect in the severe hypovolemia.

Keywords

Decompensated hemorrhage; Hydroxyethyl starch; Rats; Shock; Intravital microscopy

Cite the article

Hitosugi T, Saito T, Oi Y. The Degree of Vascular Leak of Hydroxyethyl Starch in Severe Hemorrhagic Shock in Rats. Clin Surg. 2018; 3: 2021.