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Titolo:
THE PHARMACOKINETICS OF ACETYL STARCH AS A PLASMA-VOLUME EXPANDER IN PATIENTS UNDERGOING ELECTIVE SURGERY
Autore:
BEHNE M; THOMAS H; BREMERICH DH; LISCHKE V; ASSKALI F; FORSTER H;
Indirizzi:
UNIV FRANKFURT KLINIKUM,ZENTRUM ANASTHESIOL & WIEDERBELEBUNG,DEPT ANESTHESIOL & RESUSCITAT D-60590 FRANKFURT GERMANY UNIV FRANKFURT KLINIKUM,DEPT EXPT ANESTHESIOL D-60590 FRANKFURT GERMANY MAYO CLIN & MAYO FDN,DEPT ANESTHESIOL ROCHESTER MN 55905 MAYO CLIN & MAYO FDN,DEPT PHYSIOL ROCHESTER MN 55905 MAYO CLIN & MAYO FDN,DEPT BIOPHYS ROCHESTER MN 55905
Titolo Testata:
Anesthesia and analgesia
fascicolo: 4, volume: 86, anno: 1998,
pagine: 856 - 860
SICI:
0003-2999(1998)86:4<856:TPOASA>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
HYDROXYETHYL STARCH; ANAPHYLACTOID REACTIONS; SUBSTITUTES;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
23
Recensione:
Indirizzi per estratti:
Citazione:
M. Behne et al., "THE PHARMACOKINETICS OF ACETYL STARCH AS A PLASMA-VOLUME EXPANDER IN PATIENTS UNDERGOING ELECTIVE SURGERY", Anesthesia and analgesia, 86(4), 1998, pp. 856-860

Abstract

Acetyl starch (ACS) is a new synthetic colloid solution for plasma volume expansion and is now undergoing phase 2 clinical trials. We compared the pharmacokinetics of ACS with those of hydroxyethyl starch (HES) in 32 patients (ASA physical status I and II) undergoing elective surgery. Ln this randomized, double-blind trial, patients received either 15 mL/kg ACS 6% (average molecular weight [Mw] 200,000/molar substitution [MS] 0.5) or HES 6% (Mw 200,000/MS 0.5) IV up to a maximal dose of 1000 mt. Plasma colloid concentrations were measured by repetitive arterial blood sampling over 2 1.5 h. Plasma colloid concentrations were detected using a high-pressure liquid chromatography controlled enzymatic test. Standard pharmacokinetics were calculated, including initial half-life (t(1/2init)), i.e., the time required for a 50% decline of the maximal plasma colloid concentration at the end of drug infusion. Whereas HES was eliminated by second-order kinetics, ACS followed first-order characteristics. In the first hours after IV administration, t 1/2init and clearances were similar in both groups. However, the terminal half-life of HES was significantly longer than that of ACS (9.29 +/- 1.43 h vs 4.37 +/- 1.06 h). After 16.5 and 24.5 h, ACS showed significantly lower plasma concentrations than HES, which indicates that the final degradation of ACS by esterases and amylase was significantly more rapid. ACS might be an alternative plasma volume expander, which avoids the accumulation of persisting macromolecules. Implications: We studied the pharmacokinetics of acetyl starch, a newly developed colloid solution for plasma volume substitution compared with hydroxyethyl starch in 32 surgical patients undergoing elective major general surgical procedures. In contrast to hydroxyethyl starch, this new agent undergoes rapid and nearly complete enzymatic degradation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/09/20 alle ore 18:46:41