Anesthesiology’s journal-based CME program is open to all readers. Members of the American Society of Anesthesiologists participate at a preferred rate, but you need not be an ASA member or a journal subscriber to take part in this CME activity. Please complete the following steps:
Read the article by Kozek-Langenecker entitled “Effects of hydroxyethyl starch solutions on hemostasis” on page 654 of this issue.
Review the questions and other required information for CME program completion (published in both the print and online journal).
When ready, go to the CME Web site: http://www.asahq.org/journal-cme. Submit your answers, form of payment, and other required information by December 31 of the year following the year of publication.
The American Society of Anesthesiologists is approved by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.
The American Society of Anesthesiologists designates this continuing medical education program for a maximum of 1 hour of Category 1 credit toward the AMA’s Physician Recognition Award. Each physician should claim only those hours of credit actually spent in the activity.
Purpose: The focus of the journal-based CME program, and the articles chosen for the program, is to educate readers on current developments in the science and clinical practice of the specialty of Anesthesiology.
Target Audience: Physicians and other medical professionals whose medical specialty is the practice of anesthesia.
Learning Objectives: After reading this article, participants should have a better understanding of the pharmacology, use, and limitations of hydroxyethyl starch solutions.
Disclosure Information:
Authors –Sibylle A. Kozek-Langenecker, M.D.
Grants or research support: None
Consultantships or honoraria: None
The article authored by Dr. Kozek-Langenecker was supported solely from institutional and/or departmental sources.
Question Writer –Peter L. Bailey, M.D.
Dr. Bailey has no grants, research support, or consultant positions, nor does he receive any honoraria from outside sources, which may create conflicts of interest concerning this CME program.
Article Questions
Based on the article by Kozek-Langenecker entitled “Effects of hydroxyethyl starch solutions on hemostasis”http://content.wkhealth.com/linkback/openurl/trusted?issn=0003-3022&volume=103&issue=3&spage=654&part=fulltextin the September issue of Anesthesiology, choose the one correct answer for each question:
Which of the following statements concerning hydroxyethyl starch (HES) solutions is most likely true?
A. Each HES product has one particular molecular weight.
B. The number of hydroxyl-ethyl residues does not influence HES physicochemical characteristics.
C. The pattern of hydroxyethylation (e.g. , C2 carbon in a glucose subunit) does not influence HES physicochemical characteristics.
D. Larger HES molecules are hydrolyzed by serum α-amylase.
Which of the following statements concerning the adverse or side effects of HES solutions is most likely true?
A. Hemostasis is not affected.
B. Allergic reactions are more common compared to other colloid volume expanders.
C. Long-term infusions can cause pruritus.
D. There is no risk of renal dysfunction.
Which of the following statements concerning coagulopathic bleeding associated with the administration of HES solutions in surgery patients is most likely true?
A. It is less likely to occur with the use of slowly degradable HES solutions.
B. It is not associated with an increased activated partial thromboplastin time.
C. It is related to a factor VIII deficiency.
D. It is not associated with a von Willebrand factor–type deficiency.
Factors that can contribute to bleeding associated with perioperative HES solution administration include all of the following except
A. The decrease in factor VIII which is part of postoperative acute phase reactions
B. Decreased platelet function
C. Hemodilution
D. The solvent composition of HES solutions
Which of the following statements concerning volume expanders is most likely true?
A. The duration of the expansion effects of HES solutions is predicted by the pharmacokinetics of the particular HES molecule.
B. Restricted use of slowly degradable HES solutions is recommended when hemostatic competence is critical.
C. Most HES solutions produce considerable volume expansion effects beyond the 24 hours after their administration.
D. Compared to albumin-based or gelatin volume expanders, only HES solutions induce platelet dysfunction.
