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British Journal of Anaesthesia, Vol 82, Issue 4 510-515, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia

CLINICAL INVESTIGATIONS

Tissue deposits of hydroxyethyl starch (HES): dose-dependent and time- related

C. Sirtl, H. Laubenthal, V. Zumtobel, D. Kraft and W. Jurecka
Department of Anaesthesiology and Department of Surgery, St Josef-Hospital, Ruhr-Universitat Bochum, Gudrunstr. 56, D-44791 Bochum, Germany; Institute of General and Experimental Pathology and Department of Dermatology, Division of General Dermatology, University of Vienna, Vienna, Austria

Tissue deposits occur after administration of plasma substitutes. After hydroxyethyl starch (HES), deposits may last for months, causing pruritus and impairment of function. Because elimination of HES deposits has not been demonstrated in humans, we studied 26 patients, for up to 7 yr after HES administration, to assess HES storage. HES dose ranged from 0.34 to 15.00 g kg-1 body weight, and administration intervals from 1 day to 7 yr. Biopsies of the liver, muscle, spleen, intestine or skin were studied using light and electron microscopy and immunohistochemistry. HES storage was dose-dependent, decreased in all organs with time and was greater in patients suffering from pruritus. We conclude that tissue deposition of HES is transitory and dose- dependent, with differences between subjects in severity and duration.
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