INTRODUCTION The aim of the study was to evaluate some of the underlying pathomechanisms of hydroxyethylstarch (HES) induced adverse effects on renal function using 24 porcine kidneys in an isolated perfusion model over six hours. METHODS Infusion of either 10% HES 200/0.5, 6% HES 130/0.42 or Ringer's lactate (RL) was performed to achieve an haematocrit of 20% in eight kidneys from four anima...

background spinal anesthesia is an important and commonly used method for surgical anesthetic in operating rooms. however, even with identical drug dosage and administration mode, the extent of drug distribution in vivo is highly variable and difficult to control. preanesthetic administration of fluids immediately before spinal anesthesia (preload) is normal practice. the choice of fluid type m...

BACKGROUND Third-generation hydroxyethyl starch (HES) solutions have been developed to minimize negative effects on hemostasis. In normal pregnancy, the coagulation activity increases, reaching a maximum around term. This study examined the effects of hemodilution with HES 130/0.4 (6%) on blood coagulation in parturients in vivo and in vitro. METHODS Forty parturients scheduled for cesarean s...

BACKGROUND 6% Hydroxyethyl Starch 130/0.4 in 0.9% Sodium Chloride (Voluven®; 6% HES 130/0.4) is a colloid often used for fluid resuscitation in patients with subarachnoid hemorrhage (SAH), despite a lack of safety data for this use. The purpose of our study was to evaluate the effect of 6% HES 130/0.4 on major complications associated with SAH. METHODS Medical records of all patients presenti...

hydroxyethyl starch (HES) 130/0.4 in 9,587 patients and a meta-analysis evaluating HES 130/0.42 in 804 patients, HES 130 was shown to increase mortality and the need for renal replacement therapy (RRT) [1]. In the largest included trial of the meta-analysis, the Crystalloid versus Hydroxyethyl Starch Trial (CHEST) with 7,000 ICU patients [2], HES 130/0.4 increased the need for RRT despite a low...

BACKGROUND Hydroxyethyl starches (HES) accumulate in the circulation when administered repeatedly. Accumulation is thought to be partly responsible for undesirable effects (tissue storage, blood coagulation impairment, and itching). HES 130/0.42 with low molecular weight and a low level of substitution has recently been developed in order to reduce those risks. METHODS In healthy volunteers, ...

INTRODUCTION Hydroxyethyl starch (HES) solutions are widely used for volume replacement therapy but are also known to compromise coagulation, impair renal function and increase long-term mortality. To test the hypotheses that HES 130/0.4 has fewer adverse effects than HES 200/0.5 and exerts anti-inflammatory properties, we compared the effects of HES 130/0.4, HES 200/0.5 and saline on in vitro ...

BACKGROUND The gut is considered an important target organ of injury after severe insult such as sepsis, trauma and shock. Hydroxyethyl starch (HES) 130/0.4 has been developed to improve the pharmacokinetics of current medium molecular weight HES solutions. We investigated the protective effects of HES 130/0.4 on intestinal inflammatory response and survival in a rat polymicrobial sepsis model ...

BACKGROUND Hydroxyethyl starch (HES) is used for fluid replacement in millions of patients around the world every year, yet it has been found to have adverse effects that have a negative impact on patient survival. Recent clinical trials with a modern HES solution (HES 130) and meta-analyses now enable a reassessment of its risks and benefits. METHODS On the basis of a selective literature se...

BACKGROUND The chemical inertness of hydroxyethyl starch (HES) might cause interferences of the colloid with a variety of laboratory tests. We aimed to evaluate potential influences of HES 130/0.4, the newest HES type, on several common hematology and clinical chemistry parameters. METHODS AND RESULTS A convenient sample of 25 patients scheduled for rheological therapy with 500 mL 6% HES 130/...