FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Journal of veterinary internal medicine2013; 28(1); 223-233; doi: 10.1111/jvim.12245

Cardiovascular, colloid osmotic pressure, and hemostatic effects of 2 formulations of hydroxyethyl starch in healthy horses.

Abstract: Lower molecular weight and molar substitution formulations of hydroxyethyl starch (HES) solutions might maximize cardiovascular function and colloid osmotic pressure (COP) and minimize adverse effects on coagulation. Objective: To compare effects of 1 low and 1 high molecular weight and molar substitution HES solution on cardiovascular variables, COP, and hemostasis in normal horses. Methods: Eight healthy adult horses. Methods: Randomized, crossover designed study: 10 mL/kg bolus of 6% HES (600/0.75) (hetastarch) (HS), 6% HES (130/0.4) tetrastarch (TS), and 0.9% NaCl (NS). Variables recorded included central venous pressure (CVP), noninvasive arterial blood pressure, packed cell volume (PCV), COP, and automated platelet analysis (CT). Results: Central venous pressure was increased for 8 hours after all treatment (baseline = 8.4 ± 3.8; 8 hours = 10.3 ± 3.5 cm H2 O; P < .001). HS and TS produced an increase in systolic arterial pressure (HS = 109.1 ± 11.9; TS = 109.5 ± 10.9 mmHg) and mean arterial pressure (HS = 80.4 ± 13.0; TS = 82.3 ± 10.1 mmHg) compared to NS (SAP = 103.2 ± 13.2 [P = .023]; MAP = 74.2 ± 11.4 mmHg [P = .048]). PCV decreased transiently with HS (baseline = 37.1 ± 4.4%; 1.5 hours = 31.6 ± 3.9%) and TS (baseline = 38.4 ± 3.9%; 1.5 hours = 32.2 ± 3.3%), but not NS (P = .007). COP was greater with HS (1 hour; 24.0 ± 2.1 mmHg) and TS (8 hours; 25.9 ± 2.1 mmHg) than NS (1 hour = 20.8 ± 2.6; 8 hours = 22.9 ± 3.1 mmHg; P < .001). CT was greater at 8 (HS = 178.6 ± 36.9; TS = 121.9 ± 33.3; NS = 108.3 ± 23.6 seconds) and 24 hours (HS = 174.2 ± 41.7; TS = 100.8 ± 26.0; NS = 118.7 ± 38.7 seconds; P < .001) in horses receiving HS than TS or NS. Conclusions: Both TS and HS resulted in more effective volume expansion and arterial pressure support than NS. TS produced a more sustained effect on COP with shorter duration of adverse effects on platelet function than HS.
Copyright © 2013 by the American College of Veterinary Internal Medicine.
Get Full Text
Publication Date: 2013-11-13 PubMed ID: 24428324PubMed Central: PMC4895541DOI: 10.1111/jvim.12245Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article
  • Research Support
  • Non-U.S. Gov't

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research examines the cardiovascular, colloid osmotic pressure, and hemostatic effects of two different forms of hydroxyethyl starch (HES) in healthy horses. The study findings suggest that both high and low molecular weight HES can effectively enhance volume expansion and arterial pressure, with the tetrastarch (TS) version proving more effective in sustaining colloid osmotic pressure and having less adverse impact on platelet function.

Research Objectives and Methods

  • The main objective of the study was to analyse and compare the effects of two HES solutions differing in molecular weight and molar substitution on equine cardiovascular parameters, colloid osmotic pressure (COP), and hemostasis.
  • The research model involved eight healthy adult horses, which were subjected to a randomized crossover study design. Each horse received boluses of high molecular weight HES (named hetastarch or HS), lower molecular weight HES (called tetrastarch or TS), and a saline solution (designated as NS).
  • Several physiological parameters were measured, including central venous pressure (CVP), arterial blood pressure, packed cell volume (PCV), COP, and coagulation times, which were assessed using automated platelet analysis (CT).

Results of the Study

  • The results showed that CVP was elevated for 8 hours following all treatments. Both HS and TS caused an increase in systolic (SAP) and mean arterial pressure (MAP) compared to the saline solution.
  • PCV temporarily dropped with HS and TS, but this was not observed with NS. The COP was higher for both HS (at 1 hour) and TS (at 8 hours) than the saline solution.
  • Coagulation times were lengthier at 8 and 24 hours in horses given HS rather than TS or saline, indicating a more prolonged adverse effect on platelet function.

Conclusions

  • The research concluded that both HS and TS were more efficient than saline at facilitating volume expansion and supporting arterial pressure in horses.
  • When compared to HS, TS demonstrated a more lasting effect on COP and showed a shorter duration of adverse effects on platelet function, making it potentially the more desirable option for this application.

Cite This Article

APA
Epstein KL, Bergren A, Giguère S, Brainard BM. (2013). Cardiovascular, colloid osmotic pressure, and hemostatic effects of 2 formulations of hydroxyethyl starch in healthy horses. J Vet Intern Med, 28(1), 223-233. https://doi.org/10.1111/jvim.12245

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 28
Issue: 1
Pages: 223-233

Researcher Affiliations

Epstein, K L
  • Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA.
Bergren, A
    Giguère, S
      Brainard, B M

        MeSH Terms

        • Animals
        • Blood Pressure / physiology
        • Cross-Over Studies
        • Female
        • Hemostasis
        • Horses / physiology
        • Hydroxyethyl Starch Derivatives / administration & dosage
        • Hydroxyethyl Starch Derivatives / pharmacology
        • Infusions, Intravenous / veterinary
        • Male
        • Osmotic Pressure / physiology
        • Partial Thromboplastin Time / veterinary
        • Plasma Substitutes / administration & dosage
        • Plasma Substitutes / pharmacology
        • Platelet Aggregation / physiology
        • Prothrombin Time / veterinary
        • Random Allocation

        References

        This article includes 27 references
        1. Silverstein DC, Aldrich J, Haskins S. Assessment of changes inblood volume in response to resuscitative fluid administration.. J Vet Emerg Crit Care (San Antonio) 2005;15:185–192.
        2. Hallowell GD, Corley KT. Preoperative administration of hydroxyethyl starch or hypertonic saline to horses with colic.. J Vet Intern Med 2006 Jul-Aug;20(4):980-6.
          pubmed: 16955826doi: 10.1892/0891-6640(2006)20[980:paohso]2.0.co;2google scholar: lookup
        3. Jones PA, Tomasic M, Gentry PA. Oncotic, hemodilutional, and hemostatic effects of isotonic saline and hydroxyethyl starch solutions in clinically normal ponies.. Am J Vet Res 1997 May;58(5):541-8.
          pubmed: 9140565
        4. Jungheinrich C. The starch family: Are they all equal? Pharmacokinetics and pharmacodynamics of hydroxyethyl starches.. Transfus Altern Transfus Med 2007;9:152–163.
        5. Van der Linden P, Ickx BE. The effects of colloid solutions on hemostasis.. Can J Anaesth 2006 Jun;53(6 Suppl):S30-9.
          pubmed: 16766789doi: 10.1007/bf03022250google scholar: lookup
        6. de Jonge E, Levi M. Effects of different plasma substitutes on blood coagulation: a comparative review.. Crit Care Med 2001 Jun;29(6):1261-7.
          pubmed: 11395618doi: 10.1097/00003246-200106000-00038google scholar: lookup
        7. Deusch E, Gamsjäger T, Kress HG, Kozek-Langenecker SA. Binding of hydroxyethyl starch molecules to the platelet surface.. Anesth Analg 2003 Sep;97(3):680-683.
          pubmed: 12933382doi: 10.1213/01.ane.0000073353.31894.begoogle scholar: lookup
        8. Kozek-Langenecker SA. Effects of hydroxyethyl starch solutions on hemostasis.. Anesthesiology 2005 Sep;103(3):654-60.
          pubmed: 16129993doi: 10.1097/00000542-200509000-00031google scholar: lookup
        9. Martin G, Bennett-Guerrero E, Wakeling H, Mythen MG, el-Moalem H, Robertson K, Kucmeroski D, Gan TJ. A prospective, randomized comparison of thromboelastographic coagulation profile in patients receiving lactated Ringer's solution, 6% hetastarch in a balanced-saline vehicle, or 6% hetastarch in saline during major surgery.. J Cardiothorac Vasc Anesth 2002 Aug;16(4):441-6.
          pubmed: 12154422doi: 10.1053/jcan.2002.125146google scholar: lookup
        10. Wierenga JR, Jandrey KE, Haskins SC, Tablin F. In vitro comparison of the effects of two forms of hydroxyethyl starch solutions on platelet function in dogs.. Am J Vet Res 2007 Jun;68(6):605-9.
          pubmed: 17542692doi: 10.2460/ajvr.68.6.605google scholar: lookup
        11. Smart L, Jandrey KE, Kass PH, Wierenga JR, Tablin F. The effect of Hetastarch (670/0.75) in vivo on platelet closure time in the dog.. J Vet Emerg Crit Care (San Antonio) 2009 Oct;19(5):444-9.
          pubmed: 19821885doi: 10.1111/j.1476-4431.2009.00464.xgoogle scholar: lookup
        12. Pantaleon LG, Furr MO, McKenzie HC, Donaldson L. Effects of small- and large-volume resuscitation on coagulation and electrolytes during experimental endotoxemia in anesthetized horses.. J Vet Intern Med 2007 Nov-Dec;21(6):1374-9.
          pubmed: 18196749doi: 10.1892/06-289.1google scholar: lookup
        13. Schusser GF, Rieckhoff K, Ungemach FR, Huskamp NH, Scheidemann W. Effect of hydroxyethyl starch solution in normal horses and horses with colic or acute colitis.. J Vet Med A Physiol Pathol Clin Med 2007 Dec;54(10):592-8.
          pubmed: 18045345doi: 10.1111/j.1439-0442.2007.01007.xgoogle scholar: lookup
        14. Blong AE, Epstein KL, Brainard BM. In vitro effects of three formulations of hydroxyethyl starch solutions on coagulation and platelet function in horses.. Am J Vet Res 2013 May;74(5):712-20.
          pubmed: 23627384doi: 10.2460/ajvr.74.5.712google scholar: lookup
        15. Treib J, Baron JF, Grauer MT, Strauss RG. An international view of hydroxyethyl starches.. Intensive Care Med 1999 Mar;25(3):258-68.
          pubmed: 10229159doi: 10.1007/s001340050833google scholar: lookup
        16. Salmon JB, Mythen MG. Pharmacology and physiology of colloids.. Blood Rev 1993 Jun;7(2):114-20.
          pubmed: 7690276doi: 10.1016/s0268-960x(05)80021-9google scholar: lookup
        17. Jungheinrich C, Neff TA. Pharmacokinetics of hydroxyethyl starch.. Clin Pharmacokinet 2005;44(7):681-99.
          pubmed: 15966753doi: 10.2165/00003088-200544070-00002google scholar: lookup
        18. Konrad CJ, Markl TJ, Schuepfer GK, Schmeck J, Gerber HR. In vitro effects of different medium molecular hydroxyethyl starch solutions and lactated Ringer's solution on coagulation using SONOCLOT.. Anesth Analg 2000 Feb;90(2):274-9.
          pubmed: 10648306doi: 10.1097/00000539-200002000-00007google scholar: lookup
        19. Westphal M, James MF, Kozek-Langenecker S, Stocker R, Guidet B, Van Aken H. Hydroxyethyl starches: different products--different effects.. Anesthesiology 2009 Jul;111(1):187-202.
          pubmed: 19512862doi: 10.1097/aln.0b013e3181a7ec82google scholar: lookup
        20. Franz A, Bräunlich P, Gamsjäger T, Felfernig M, Gustorff B, Kozek-Langenecker SA. The effects of hydroxyethyl starches of varying molecular weights on platelet function.. Anesth Analg 2001 Jun;92(6):1402-7.
          pubmed: 11375812doi: 10.1097/00000539-200106000-00008google scholar: lookup
        21. Brainard BM, Epstein KL, LoBato D, Kwon S, Papich MG, Moore JN. Effects of clopidogrel and aspirin on platelet aggregation, thromboxane production, and serotonin secretion in horses.. J Vet Intern Med 2011 Jan-Feb;25(1):116-22.
          pubmed: 21143302doi: 10.1111/j.1939-1676.2010.0647.xgoogle scholar: lookup
        22. Epstein KL, Brainard BM, Giguere S, Vrono Z, Moore JN. Serial viscoelastic and traditional coagulation testing in horses with gastrointestinal disease.. J Vet Emerg Crit Care (San Antonio) 2013 Sep-Oct;23(5):504-16.
          pubmed: 24028350doi: 10.1111/vec.12095google scholar: lookup
        23. Babski DM, Brainard BM, Krimer PM, Ralph AG, Pittman JR, Koenig A. Sonoclot evaluation of whole blood coagulation in healthy adult dogs.. J Vet Emerg Crit Care (San Antonio) 2012 Dec;22(6):646-52.
          pubmed: 23216839doi: 10.1111/j.1476-4431.2012.00820.xgoogle scholar: lookup
        24. Kingston JK, Bayly WM, Sellon DC, Meyers KM, Wardrop KJ. Effects of sodium citrate, low molecular weight heparin, and prostaglandin E1 on aggregation, fibrinogen binding, and enumeration of equine platelets.. Am J Vet Res 2001 Apr;62(4):547-54.
          pubmed: 11327462doi: 10.2460/ajvr.2001.62.547google scholar: lookup
        25. Gandhi SD, Weiskopf RB, Jungheinrich C, Koorn R, Miller D, Shangraw RE, Prough DS, Baus D, Bepperling F, Warltier DC. Volume replacement therapy during major orthopedic surgery using Voluven (hydroxyethyl starch 130/0.4) or hetastarch.. Anesthesiology 2007 Jun;106(6):1120-7.
          pubmed: 17525586doi: 10.1097/01.anes.0000265422.07864.37google scholar: lookup
        26. Jungheinrich C, Sauermann W, Bepperling F, Vogt NH. Volume efficacy and reduced influence on measures of coagulation using hydroxyethyl starch 130/0.4 (6%) with an optimised in vivo molecular weight in orthopaedic surgery : a randomised, double-blind study.. Drugs R D 2004;5(1):1-9.
          pubmed: 14725484doi: 10.2165/00126839-200405010-00001google scholar: lookup
        27. Casutt M, Kristoffy A, Schuepfer G, Spahn DR, Konrad C. Effects on coagulation of balanced (130/0.42) and non-balanced (130/0.4) hydroxyethyl starch or gelatin compared with balanced Ringer's solution: an in vitro study using two different viscoelastic coagulation tests ROTEMTM and SONOCLOTTM.. Br J Anaesth 2010 Sep;105(3):273-81.
          pubmed: 20659913doi: 10.1093/bja/aeq173google scholar: lookup

        Citations

        This article has been cited 8 times.
        1. Boyd CJ, Brainard BM, Smart L. Intravenous Fluid Administration and the Coagulation System. Front Vet Sci 2021;8:662504.
          doi: 10.3389/fvets.2021.662504pubmed: 33937383google scholar: lookup
        2. Crabtree NE, Epstein KL. Current Concepts in Fluid Therapy in Horses. Front Vet Sci 2021;8:648774.
          doi: 10.3389/fvets.2021.648774pubmed: 33855057google scholar: lookup
        3. Kopper JJ, Kogan CJ, Cook VL, Schott HC 2nd. Outcome of horses with enterocolitis receiving oncotic fluid support with either plasma or hetastarch. Can Vet J 2019 Nov;60(11):1207-1212.
          pubmed: 31692633
        4. Shaw SD, Stämpfli H. Diagnosis and Treatment of Undifferentiated and Infectious Acute Diarrhea in the Adult Horse. Vet Clin North Am Equine Pract 2018 Apr;34(1):39-53.
          doi: 10.1016/j.cveq.2017.11.002pubmed: 29426709google scholar: lookup
        5. Hepworth-Warren KL, Wong DM, Hay-Kraus BL, Wang C, Sun Y. Effects of administration of a synthetic low molecular weight/low molar substitution hydroxyethyl starch solution in healthy neonatal foals. Can Vet J 2015 Oct;56(10):1069-74.
          pubmed: 26483583
        6. Bellezzo F, Kuhnmuench T, Hackett ES. The effect of colloid formulation on colloid osmotic pressure in horses with naturally occurring gastrointestinal disease. BMC Vet Res 2014;10 Suppl 1(Suppl 1):S8.
          doi: 10.1186/1746-6148-10-S1-S8pubmed: 25237987google scholar: lookup
        7. Woods Cuneo S, Abi-Nader BA, Blasczynski SJ, Chigerwe M. Effects of Plasma and Hetastarch Administration on Colloid Oncotic Pressure and Coagulation Variables in Dairy Calves and Goats. J Vet Intern Med 2025 May-Jun;39(3):e70079.
          doi: 10.1111/jvim.70079pubmed: 40375567google scholar: lookup
        8. Shin DY, Park JS, Lee HS, Shim W, Jin L, Lee KW, Park JB, Kim DH, Kim JH. The effect of hydroxyethyl starch as a cryopreservation agent during freezing of mouse pancreatic islets. Biochem Biophys Rep 2024 Jul;38:101658.
          doi: 10.1016/j.bbrep.2024.101658pubmed: 38362049google scholar: lookup
        Subscribe to our newsletter
        Join 99,850 horse owners like you who receive our email updates on horse health and nutrition.