hydroxyethylstarch + albumin

Hydroxyethylstarch + albumin is a combination of two colloid plasma volume expanders used for intravenous fluid replacement, particularly in settings of hypovolemia due to blood loss, trauma, or surgery. Hydroxyethyl starch (HES) is a synthetic polymer derived from amylopectin and acts as an artificial colloid to maintain or restore intravascular volume by increasing oncotic pressure and reducing capillary leakage. Albumin is a natural plasma protein purified from human blood that also increases oncotic pressure and helps retain fluid within the vasculature. Both agents are used as alternatives to crystalloids for volume resuscitation; however, their safety profiles differ. HES has been associated with increased risks of acute kidney injury and coagulopathy compared to albumin[4][5][9]. Albumin may have protective effects on the vascular barrier through interaction with the endothelial glycocalyx[1]. The combination may be considered in specific clinical scenarios such as plasma exchange or when both rapid volume expansion and maintenance of oncotic pressure are desired[7].