Acute effects of hydroxyaethyl starch vs dextran on the metabolism of the ischemic leg

Abstract

This study compared the acute effects of a daily infusion (for 6 days) of 10% hydroxyethyl starch (Hes) (n =6) vs 10% dextran 40 (n=8) in claudicants. During exercise on a pedal ergometer at the maximal force, O₂ extraction and lactate production of the diseased leg as well as blood pressure, heart rate, hematocrit and blood viscosity were measured. After a single infusion of 500 ml Hes lactate, production decreased by 52 ± 22% (p < 0.05), with a concomitant increase of O₂ extraction and maximal exercise capacity. In contrast to dextran where no changes were observed after a single dose, Hes also increased the systolic blood pressure. After 6 days of hypervolemic hemodilution therapy, hematocrit was lowered and blood pressure increased with a comparable increase of O₂ extraction and maximal exercise capacity in both groups. We conclude that the decreased lactate production with the concomitant increase of O₂ extraction and maximal exercise capacity is due to the increased blood pressure.