Journal für Anästhesie und Intensivbehandlung 3/1998

Quantitative Measurement Regarding the Tissue Storage of Middle Molecular Hydroxyethyl Starch 200/0,5 in Patients with Multiple Organ Failure
P. Lukasewitz, U. Kroh, O. Löwenstein, M. Krämer, H. Lennartz

Objective: Quantitative determination of the concentration of hydroxyethyl starch (HES) in different organs (liver, kidney, lung, spleen, pancreas, lymphnodes and small intestine) in 12 deceased patients of ICU. Patients and methods: Primarily the patients had been treated because of respiratory insufficiency (ARDS) of various causes. Persistent sepsis and multi organ failure resulted in their death. All of them had been continuously veno-venous haemofiltrated (CVVH) over a longer period because of acute renal failure. The patients received an average of 9,42 l ± 3,85 l HES 200/0,5 (942 ± 385 g hydroxyethyl starch) during the time of 41 ± 22 days. Analysis has been performed in a modified chemical method to measure glycogen. Results: We found the highest quantities of HES concentration in all patients in the kidneys (up to 26,4 mg/g), the lowest quantities we determined in the pancreas and small intestine. All in all only about 3% - 4% of the infused amount of HES could be detected in the investigated organs. Conclusions: The accumulated mass of HES in the organs is very low. From our investigations we conclude, that intracellular cleavage of HES molecules in patients with renal failure is more relevant than intravasale hydrolysis.

Key words: Hydroxyethyl starch, tissue storage, multiple organ failure

Dr. P. Lukasewitz
Abteilung für Anästhesie und Intensivtherapie
Klinikum der Philipps-Universität Marburg
Baldingerstr. 1
D-35043 Marburg

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