Which Hydroxyethyl Starch for Which Indication?
Plasma substitutes are widely used to maintain circulatory dynamics during various types of shock. Plasma volume can be expanded with several types of colloids, belonging to four pharmacological families: gelatins, dextrans, starches, and albumin. Rather than attempting to determine which type of solution is superior to others, we consider it appropriate to outline the proper role of each in the context of its specific indications and characteristics. This chapter defines advantages and side effects of the use of starches in treating hypovolemia. Factors that are discussed include blood volume expanding efficiency, hemostasis impairment, allergic reactions, and the effect on microcirculation. Finally, indications are suggested for various clinical situations.
KeywordsHydroxyethyl Starch Anaphylactoid Reaction Colloid Osmotic Pressure Plasma Volume Expansion Plasma Substitute
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- 1.Arfors KE, Buckley PB (1997) Pharmacological characteristics of artificial colloids. Clin Anaesthesiol 11 (1):15–47Google Scholar
- 2.Haljamae H, Dahlquist M, Walentin F (1997) Artificial colloids in clinical practice: pros and cons. Clin Anaesthesiol 11 (1):49–79Google Scholar
- 3.Treib J, Haass A, Pindur G, Seyfert UT, Treib W, Grauer MT, Jung F, Wenzel E, Schimrigk K (1995) HES 200/0.5 is not HES 200/0.5. Influence of the C2/C6 hydroxyethylation ratio of hydroxyethylstarch (HES) on hemorheology coagulation and elimination kinetics. Thromb Haemost 74:1452–1456PubMedGoogle Scholar
- 5.Sirtl C, Hubner G, Jesch F (1988) Zur Speicherung von hoch und mittelmolekularer Hydroxyäthylstärke (HÄS) in meuschlichen Gewebe. Beitr Anaesthesiol Intens Med 26:74–97Google Scholar
- 16.Knippel RA, Hatangadi SB (1995) Acute hypotension related to hemorrhage in the obstetric patient. Obstet Gynecol Clin North Am 22:111–129Google Scholar