Effects of Hydroxyethyl Starch and Modified Fluid Gelatine on Phagocytic Activity of Human Neutrophils and Monocytes – Results of a Randomized, Prospective Clinical Study

Abstract

Background: Hydroxyethyl starch (HES) and modified fluid gelatine (MFG) are commonly used to replace intravascular volume. Experimental studies have revealed either an inhibitory effect or no effect of colloidal fluids on leukocyte function. We investigated prospectively the influence of several 6% HES (MW (Da) / degree of substitution: 70,000/0.5; 200,000/0.5; 450,000/0.7) and 3% MFG (MW 30,000 Da) solutions on phagocytic activity of circulating polymorphonuclear neutrophils (PMNs) and monocytes. Patients and Methods: Following ethics committee approval, venous blood was drawn from 40 urological patients (n = 10 in each group) before and 1 h after infusion with 10 ml/kg of one of the above-mentioned solutions. None of the patients had any underlying disease known to interfere with leukocyte function. The phagocytic activity of neutrophils and monocytes was measured by the uptake of fluorescein isothiocyanate(FITC)-labelled, opsonized bacteria by means of flow cytometry. Results: Phagocytic capacity of both neutrophils (94.01 ± 2.64%; mean ± SEM) and monocytes (89.80 ± 3.36%) was decreased following the application of MFG (p ≤ 0.05). No significant differences could be found in phagocytic activity following HES administration, regardless of molecular weight and degree of substitution. Conclusion: Our results indicate that leukocyte phagocytosis may vary according to the type of colloidal fluids used. The HES solutions investigated did not affect phagocytic activity of circulating PMNs and monocytes. However, leukocyte phagocytosis was impaired after MFG application.