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

Authors

  • Işın Güneş
  • Ayşegül Küçük
  • Faruk Metin Çomu
  • Volkan Şıvgın
  • Metin Alkan
  • Mustafa Arslan Gazi Üniversitesi Tıp Fakültesi
  • Yusuf Ünal

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.

References

Bagshaw SM, Bellomo R. The influence of volume management on outcome. Curr Opin Crit Care 2007;13:541–8.

Standl T, Burmeister MA, Schroeder F, Currlin E, Schulte am Esch J, Freitag M, et al. hydroxyethyl starch (HES) 130/0.4 provides larger and faster increases in tissue oxygen tension in comparison with prehemodilution values than HES 70/0.5 or HES 200/0.5 in volunteers undergoing acute normovolemic hemodilution. Anesth Analg 2003;96:936–43.

Neff TA, Fischler L, Mark M, Stocker R, Reinhart WH. The influence of two different hydroxyethyl starch solutions (6% HES 130/0.4 and 200/0.5) on blood viscosity. Anesth Analg 2005;100:1773–80.

Vijoen M, de Oliveria AA, Milne F. Physical properties of the red blood cells in chronic renal failure. Nephron 1991; 59:271-8.

Rosenmund A, Binswanger U, Straub PW. Oxidative injury to erythrocytes, red cell rigidity and splenic hemolysis in hemodialyzed uremic patients. Ann Intern Med 1975; 82:460-5.

Pekpak MA, Ercan M, Konukoğlu D, Erek E. Erythrocyte membrane stiffness (or) red cell deformability, blood and plasma viscosity in proteinüric patients. Office Journal of the Turkish Nephrology, Association 1999;4:206-12,

Çavdar C, Temiz A, Yeniçerioğlu Y, Çalışkan S, Çelik A, Sifil A, et al. The effects of intravenous iron treatment on oxidant stress and erythrocyte deformability in hemodialysis patients. Official Journal of the Turkish Society of Nephrology 2001;10:77-82.

Çomu FM, Andıç MF, Edremitlioğlu M, Dikmenoğlu N. Quercetin ve Pentoksifilinin akut böbrek yetmezliğinde böbrek perfüzyonu ve eritrosit deformabilitesine etkisi. Türk Fizyolojik Bilimler Derneği 35. Ulusal Fizyoloji Kongresi, özet kitabı,2009; poster no 31, sayfa 102.

Schortgen F, Girou E, Deye N, Brochard L, CRYCO Study Group. The risk associated with hyperoncotic colloids in patients with shock. Intensive Care Med 2008, 34:2157-68.

Schortgen F, Lacherade JC, Bruneel F, Cattaneo I, Hemery F, Lemaire F, et al. Effects of hydroxyethylstarch and gelatin on renal function in severe sepsis: a multicentre randomised study. Lancet 2001, 357:911-6.

Brunkhorst F, Engel C, Bloos F, Meier-Hellmann A, Ragaller M, Weiler N, et al. German Competence Network Sepsis (SepNet): Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med 2008; 358:125-39.

Jungheinrich C, Neff TA. Pharmacokinetics of hydroxyethyl starch. Clin Pharmacokinet 2005; 44:681-99.

Westphal M, James MF, Kozek-Langenecker S, Stocker R, Guidet B, Van Aken H. Hydroxyethyl starches: different products - different effects. Anesthesiology 2009; 111:187-202.

Singh M, Shin S. Changes in erythrocyte aggregation and deformability in diabetes mellitus: A brief review. Indian J Exp Biol 2009;47:7-15.

di Minno G, Martinez J, McKean M, de la Rosa J, Burke JF, Murphy S. Platelet dysfunction in uremia. Multifaceted defect partially corrected by dialysis. Am J Med 1985; 79: 552-9.

Castillo R, Lozano T, Escolar G, Revert L, Lopez J, Ordinas A. Defective platelet adhesion on vessel subendothelium in uremic patients. Blood 1986; 68: 337-42.

Livio M, Marchesi E, Remuzzi G, Gotti E, Mecca G, de Gaetano G. Uremic bleeding: Role of anemia and beneficial effect of red cell transfusions. Lancet 1982;11: 1013-5.

Małyszko J, Małyszko JS, Myśliwiec M, Buczko W. Hemostasis in chronic renal failure. Rocz Akad Med Bialymst 2005;50:126-31.

Goldstein DE, Little RR, Wiedmeyer HM, England JD, McKenzie EM. Glycated hemoglobin: methodologies and clinical applications. Clin Chem 1986;32: B64-70.

Weed RI, LaCelle PL, Merrill EW. Metabolic dependence of red cell detormability. J Clin Invest 1969; 48:795-809.

Noris M, Remuzzi G. Uremic bleeding: Closing the circle after 30 years of controversies. Blood 1999; 94: 2559-74.

Bull BS, Breton-Gorius J, Beutler E. Morphology of erythron. In: Williams WY, Beutler E, Erslev AJ, Lichtman MA (eds). Hematology. NewYork: Mc Graw Hill; 1991. 297-316.

McCay PB. Vitamin E: interactions with free radicals and ascorbate. Annu Rev Nutr 1985;5:323-40.

Stocks J, Offerman EL, Modell CB, Dormandy TL. The susceptibility to autoxidation of human red cell lipids in health and disease. Br J Haematol 1972;23:713-24.

Ersoy A, Ersoy C, Dilek K, Usta M, Güllülü M, Yavuz M, et al. The effect of different doses of vitamin C treatment on renal anemia. Uludağ Üniversitesi Tıp Fakültesi Dergisi 2002;28:5-9.

Yürekli İ, Uğurlu B. The effect of different priming solutions on the erythrocyte deformability and aggregation among cases undergoing elective coronary artery bypass surgery, Uzmanlık tezi, 2006;1-54.

Morariu AM, Maathuis MH, Asgeirsdottir SA, Leuvenink HG, Boonstra PW, van Oeveren W, et al. Acute isovolemic Hemodilution Triggers Proinflammatory and Procoagulatory Endothelial Activation in Vital Organs: Role of Erythrocyte Aggregation. Microcirculation 2006;13:397-409.

Downloads

Published

15.03.2018

Issue

Section

Original Research

Most read articles by the same author(s)

1 2 3 > >>