Newly developed colloid volume-expanding agents with mean molecular weights lower than currently available agents may improve outcome after stroke with fewer allergic and coagulation system side effects. The smaller molecule, however, may exacerbate ischemic cerebral edema if it accumulates in areas where ischemia has damaged the blood-brain barrier. We administered low-molecular-weight hydroxy...

PURPOSE To compare fluid replacement therapy with Hydroxyethyl starch 6% (HES) versus Ringer's lactate (RL) in a rodent model of non-septic renal ischemia. METHODS Forty male Wistar rats were randomized to receive HES 2 ml.kg(-1).hr(-1) or RL 5 ml.kg(-1).hr(-1) that underwent 30 minutes of renal ischemia followed by reperfusion. Twelve hours after kidney ischemia, the kidneys were evaluated f...

In acute clinical settings where there may be a role for antioxidant therapy, patients receive large amounts of i.v. fluids which may have antioxidant activity. To investigate such effects the antioxidant capacity of nine i.v. fluids was measured (Gelofusine, Haemaccel, 20% mannitol, 4.5% human albumin solution, fresh frozen plasma, aprotinin, N-acetylcysteine and two hydroxyethyl starch soluti...

Editor—The Fluids in Resuscitation of Severe Trauma (FIRST) randomized trial conducted by James and colleagues compared hydroxyethyl starch (HES) 130/0.4 with 0.9% saline in the resuscitation of 115 patients with severe blunt or penetrating trauma at a single centre in South Africa. In blunt trauma, which accounts for 86–97% of all traumatic injuries in Europe, 3 no differences were found betwe...

To determine the elimination of high-molecular-weight hydroxyethyl starch (HES, Mw 450,000) in normal subjects, ten volunteers were given 500 ml 6% HES solution by intravenous infusion, and serial blood and urine samples were collected for nonglucose total carbohydrate determination. On the average, 46 and 64 per cent of the dose was excreted in the urine within two and eight days, respectively...

The infusion of hydroxyethylstarch (HES) containing fluids has been extremely common worldwide over the last decade. Until recently, HES was probably the most commonly prescribed colloidal preparation in the world. Such prescription continued despite concerns that starch molecules might accumulate in vital organs and that starch preparations might decrease the coagulability of blood. These conc...

Despite ongoing controversial expert discussions the European Medicines Agency (EMA) recently recommended to suspend marketing authorisations for hydroxyethyl starch. This comment critically evaluates the line of arguments. Basically, the only indication for a colloid is intravascular hypovolemia. Crystalloid use appears reasonable to compensate ongoing extracellular losses beyond. In the hemod...

On Jan 26, 2018, the European Medicines Agency (EMA) suspended the marketing authorisations of hydroxyethyl starch (HES) solutions across the European Union.1 These intravenous solutions are often used for plasma volume replacement following acute blood loss. Evidence from highquality, investigator-initiated clinical trials in kidney donors, patients with sepsis, and in critically ill patients ...