Hydroxyethyl starch

A semi synthetic colloid solution use for fluid replacement patients undergoing major surgery because of their hypothetical ability to provide faster hemodynamic stabilization during acute hypovolemia.

Solutions are harmful when administered to critically ill patients including those with sepsis.

HES is still used in surgery under the premise that lower doses are infused under strict protocols.

In The FLASH multi center randomized clinical trial which assessed the effects of HES versus saline IV fluid system recuscitations in patients undergoing major abdominal surgery.

The primary endpoint of death in occurrence of renal, respiratory, cardiovascular, infectious, or surgical complications the saline group is favored.

HES can cause acute kidney injury even in patients who do not have kidney dysfunction at baseline.

In a randomized trial of 775 patient at increased risk of kidney injury after major abdominal surgery the outcome of mortality or major postoperative complications within 14 days after the surgery occurred in 36% in the HES group and 32% in the saline group, the difference not statistically significant (Guti2242ez E).