Hydroxyethyl Starch

Hydroxyethyl Starch (HES) is a type of intravenous fluid used for volume expansion and maintenance in patients with dehydration, hypovolemia, or fluid loss. It is a synthetic colloid, which means it has larger molecules that remain in the bloodstream longer than small-molecule crystalloids, providing more sustained fluid replacement.
HES is derived from starch, a carbohydrate obtained from plants like corn, waxy maize, or potato. It is chemically modified to enhance its safety and efficacy in the clinical setting. The hydroxyethyl groups added to the starch molecules prevent it from being broken down by enzymes in the body, reducing the risk of kidney damage and other adverse effects associated with the metabolism of traditional starches.
HES is used as a plasma volume expander in various clinical situations, such as preoperative fluid loading, perioperative fluid management, and resuscitation in critically ill patients. It is also used in patients with blood loss during surgery or trauma, as well as in those with burns or severe gastrointestinal losses. HES can help maintain blood pressure, improve organ perfusion, and support renal function by increasing intravascular volume.
Use HES cautiously and under close monitoring, as its use has been associated with increased risk of acute kidney injury, particularly in patients with pre-existing renal impairment or sepsis. Additionally, HES should be administered with care in patients with coagulation disorders or those at risk of bleeding, as it may increase the risk of bleeding complications.