hydroxyethyl starch

Hydroxyethyl starch (HES) is a synthetic colloid used for intravenous volume replacement therapy in the management of hypovolemia. Derived from amylopectin, HES is modified with hydroxyethyl groups to inhibit degradation by serum alpha-amylase, thereby prolonging its intravascular persistence. Its primary mechanism involves increasing the colloid osmotic (oncotic) pressure of the blood, which draws water into the vascular system to expand plasma volume. The specific research conducted at Linköping University Hospital, notably by Robert G. Hahn, focused on the volume kinetics of HES 130/0.4 (a medium-molecular-weight formulation) and its interaction with crystalloid solutions like acetated Ringer's. These studies utilized mathematical modeling to describe the distribution and elimination of the fluid, providing insights into the 'volume effect' and the duration of action of different HES formulations compared to standard crystalloids. While effective for volume expansion, its use has become controversial and restricted in critically ill patients due to risks of kidney injury and coagulopathy.

Brand names

VoluvenVenofundinHespanHextendVolulyteVubulix

Other names

Poly(O-2-hydroxyethyl)starchHetastarchPentastarchTetrastarch