THE EFFECT OF 6% HES (HYDROXYETHYL STARCH) 130/0.4 ON THE CONCENTRATION OF BLOOD POTASSIUM IN ORTHOPEDIC AHD (ACUTE HEMODIULUTION) PATIENTS AND ITS MECHANISM EXPLORATION

Background: Fluorescence spectroscopy method was used to analyze the interaction of 6% Hydroxyethyl starch (HES here-after) 13010.4 and K+. This interaction was further used to explain the mechanism of blood r concentration change in Acute Hemo Diulution (AHD hereafter) orthopedic patients after treatment with 6% HES13010.4. Methods: 48 patients with traumatic orthopedic fixation were chosen and divided into two group based on the trauma of the disease (24 patients in each group): ordinarily injured group and severely injured group-. After endotracheal incubation, 10% blood volume of 6% HES13010.4 was intravenously injected at a speed of 0.5 ml.kg(-1).min(-1). The HGB value, pH value and K . concentration was determined at three time points: before AHD (TO), 15min after AHD (Ti) and 30 min after AHD (T2). Florescence spectroscopy method was used to analyze the binding between 6% HES13010.4 and HSA (Human Serum Albumin), and the interaction between K+ and HAS-6% HES13010.4 complex. Results: Comparing to TO, HGB value was decreased at T1, 72 in both groups (P < 0.05). The concentration ofIC - was decreased at T1 in both groups (P<0.05) and there was no significant difference in pH value at Ti or T2 (P>0.05). The HGB value, pH value and IC+ concentration showed no significant difference at Ti or T2 time points between ordinarily injured group and severely injured group. Under fluorescence spectroscopy, a complex was first formed by 6% HES13010.4 and HSA (binding at Trp-214) with a 1:1 ratio, and K+ molecule further bound to this complex, which replaced the position of 6% HES13010.4, and decreased the K+ concentration in solution. Conclusion: The interaction between K+ and HAS-6% HES13010.4 complex is one of new reasons that cause the decrease o f transient blood K+ concentration after Voluven AHD.