Acute effects of hydroxyaethyl starch vs dextran on the metabolism of the ischemic leg

Abstract

This study compared the acute effects of a daily infusion (for 6 days) of 10% hydroxyethyl starch (Hes) (n =6) vs 10% dextran 40 (n=8) in claudicants. During exercise on a pedal ergometer at the maximal force, O2 extraction and lactate production of the diseased leg as well as blood pressure, heart rate, hematocrit and blood viscosity were measured. After a single infusion of 500 ml Hes lactate, production decreased by 52±22% (p<0.05), with a concomitant increase of O2 extraction and maximal exercise capacity. In contrast to dextran where no changes were observed after a single dose, Hes also increased the systolic blood pressure. After 6 days of hypervolemic hemodilution therapy, hematocrit was lowered and blood pressure increased with a comparable increase of O2 extraction and maximal exercise capacity in both groups. We conclude that the decreased lactate production with the concomitant increase of O2 extraction and maximal exercise capacity is due to the increased blood pressure.