The Effects of HES 130/0.4 Application on Erythrocyte Deformability in Ureteral Obstructed Rats

Işın Güneş ,Ayşegül Küçük ,Faruk Metin Çomu ,Volkan Şıvgın ,Metin Alkan ,Mustafa Arslan ,Yusuf Ünal

doi:10.12996/gmj.2018.29

Işın Güneş , Ayşegül Küçük + Show 5 more

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https://doi.org/10.12996/gmj.2018.29

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Abstract

Aim: The administration of plasma expanders is crucial for managing critically ill patients across a range of clinical conditions, including major surgery, hemorrhagic shock, and trauma. However, the effects of hydroxyethyl starch (HES) on erythrocyte aggregation remain controversial. For this reason, we aimed to investigate the effects of HES 130/0.4, performed renal insufficiency by experimentally unilateral ureteral obstruction, on erythrocyte deformability. Materials and Methods: A total of 24 rats were divided into 4 groups; Control, HES 130/0.4, Ureter Obstruction (UO) and UO-HES130/0.4. Urethral obstruction groups were treated with ketamine anesthesia with a low abdominal incision and reached to the distal of right ureter and sutured with 2.0 mersilen then waited for 3 weeks for late term renal insufficiency. 20 mL.kg-1 of HES 130/0.4 (Voluven) were infused intravenously to the HES 130/0.4 and UO-HES130/0.4 group. After 24-hour, rats were sacrificed. Deformability measurements were performed using 5% haematocrit in a phosphate-buffered saline (PBS) buffer. Results and Discussion: Relative resistance was increased in all groups compared to the control group (p<0.0001). In all groups, erythrocyte deformability index was found to be significantly higher than the control group (Group C-Group HES, p=0.023, Group C- Group UO, p<0.0001, Group C-Group UO-HES, p<0.0001). UO-HES group had significantly increased erythrocyte deformability index compared with the HES group (p=0.031, p=0.021, respectively). It was determined that HES 130/0.4 application did not change erythrocyte deformability in ureteral obstructed rats (p=0.785). Conclusion: The use of HES 130/0.4 has no negative effects on erythrocyte deformability in ureteral obstructed rats. We think that indications should be used correctly when using HES 130/0.4.

Highlights

The administration of plasma expanders is crucial for managing critically ill patients across a range of clinical conditions, including major surgery, hemorrhagic shock, and trauma [1]
In this study we investigated the effect of hydroxyethyl starch (HES) 130/0.4 on erythrocyte deformability of unilateral ureteral obstruction in rats
Erythrocyte deformability index was found to be significantly higher than the control group (Group C- Group HES, p=0.023, Group C- Group Ureter Obstruction (UO), p

Summary

Introduction

The administration of plasma expanders is crucial for managing critically ill patients across a range of clinical conditions, including major surgery, hemorrhagic shock, and trauma [1]. The decline in erythrocyte half-life in patients with renal insufficiency and a cause of the anemia is the deterioration of the balance in this system. Lipid peroxidation (LPO) in the erythrocyte membrane is accelerated, erythrocyte deformability is affected, and the splenic sequestration of erythrocytes increases and the erythrocyte side-life is shortened [4,5]. Experimental and clinical studies have shown that erythrocyte deformability deteriorates in renal failure cases [6,7,8]. Third generation hydroxyethyl starch (HES), the so-called tetrastarch (molar degree of substitution 0.4 and medium molecular weight of 130 kDa) with a reportedly improved safety profile, has led to renewed interest in the use of HES for volume therapy [12,13]

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