HyperHAES + ringer's acetate solution + sodium chloride

HyperHAES + ringer's acetate solution + sodium chloride is a combination intravenous fluid therapy used primarily for rapid correction of hypovolemia and fluid resuscitation, especially in perioperative and critical care settings. The formulation combines HyperHAES (a hypertonic solution containing hydroxyethyl starch [HES] and sodium chloride), Ringer's acetate solution (an isotonic crystalloid with electrolytes where lactate is replaced by acetate), and additional sodium chloride. - **Mechanism of Action:** - Hydroxyethyl starch acts as a plasma volume expander by increasing colloid osmotic pressure, helping to retain fluid within the intravascular space, thus improving hemodynamics in hypovolemic states[1][3][7]. - Sodium chloride provides essential electrolytes for maintaining osmotic balance. - Ringer’s acetate supplies balanced electrolytes; the use of acetate instead of lactate reduces metabolic burden on the liver and helps correct acidosis more efficiently in patients with impaired hepatic function[6][8]. This combination is indicated for acute volume replacement after blood loss or surgery, particularly when rapid plasma expansion is needed. It has been shown to improve cardiac output, microcirculation, oxygen transport parameters, diuresis, and overall fluid balance without significant adverse effects in short-term use[3]. However, HES-containing solutions have raised safety concerns regarding renal injury and coagulation disturbances in certain populations[7].