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Intensive Care Medicine pp 233–242Cite as

Old versus New Starches: What do We Know about their Differences?

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Abstract

Fluid therapy is the mainstay of critical care with the goal of restoring the circulating intravascular volume, maintaining organ perfusion, and reestablishing the balance between oxygen demand and delivery. Colloids are used as plasma expanders on the grounds that these macromolecules remain in the vasculature longer than crystalloids and, therefore, increase cardiac preload with less fluid needed than crystalloids. Hydroxyethyl starches (HES) are synthetic colloids which are popular plasma expanders in Europe [1–3]. However, evidence is accumulating that HES administration has adverse effects on kidney function, coagulation, and even may increase mortality in patients with severe sepsis [4–8]. Critics of these studies argue that outdated HES solutions were used and that ‘new’ HES solutions are safer and can be used without concern [9, 10]. HES 130/0.4 (tetrastarch) is the latest solution, available in Europe since 2000 and recently also in the US [11]. This chapter summarizes the evidence about the safety of ‘old’ and ‘new’ HES solutions.

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Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care, Friedrich-Schiller University, Erlanger Allee 101, 07743, Jena, Germany

    C. Hartog, F. M. Brunkhorst & K. Reinhart

Authors
  1. C. Hartog
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  2. F. M. Brunkhorst
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  3. K. Reinhart
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Editors and Affiliations

  1. Department of Intensive Care Erasme Hospital, Universitée libre de Bruxelles, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Head) (Head)

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Hartog, C., Brunkhorst, F.M., Reinhart, K. (2009). Old versus New Starches: What do We Know about their Differences?. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-92278-2_22

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  • DOI: https://doi.org/10.1007/978-0-387-92278-2_22

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-92277-5

  • Online ISBN: 978-0-387-92278-2

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