Hetastarch

( Hydroxyethyl Starch ; HES )

Pronunciation: HET-uh-starch
Class: Plasma expander

Trade Names

Hespan
- Injection 6 g per 100 mL in sodium chloride 0.9%

Voluven
- Injection 6 g per 100 mL in sodium chloride 0.9%

Pharmacology

Produces expansion of plasma volume. Does not have oxygen-carrying capacity or contain plasma protein, so it is not blood or plasma substitute.

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Pharmacokinetics

Elimination

Hetastarch is eliminated renally, and the mean t 1/ 2 is 17 days.

Indications and Usage

Adjunct therapy for plasma volume expansion in shock caused by hemorrhage, burns, surgery, sepsis, or other trauma; adjunct in leukapheresis to improve harvesting and increase yield of granulocytes.

Contraindications

Severe bleeding disorders; severe cardiac failure; renal failure with oliguria or anuria.

Dosage and Administration

Plasma Volume Expansion
Adults

IV 500 to 1,000 mL/day; dosage does not usually exceed 1,500 mL/day.

Leukapheresis
Adults

IV 250 to 700 mL.

General Advice

  • For IV infusion only.
  • Do not use if solution is turbid deep brown or if crystalline precipitate forms.

Storage/Stability

Store at room temperature, not exceeding 104°F. Do not freeze.

Drug Interactions

None well documented.

Laboratory Test Interactions

May alter coagulation and result in transient prolongation of prothrombin time (PT), partial thromboplastin time (PTT), bleeding and clotting times, decreased Hct and excessive plasma protein dilution; increases indirect bilirubin concentrations.

Adverse Reactions

CNS

Headache.

Dermatologic

Itching.

EENT

Submaxillary and parotid glandular enlargement.

GI

Vomiting.

Miscellaneous

Anaphylactoid reactions (eg, periorbital edema, urticaria, wheezing, mild temperature elevation); chills; mild influenza-like symptoms; muscle pain; peripheral edema of lower extremities.

Precautions

Pregnancy

Category C .

Lactation

Undetermined.

Children

No data available.

Hypersensitivity

May cause anaphylactoid reactions.

Special Risk Patients

Caused by possibility of circulatory overload, take special care when administering to patients with renal impairment, at risk of pulmonary edema, or with CHF.

Patient Information

  • Instruct patient to report these symptoms to health care provider: itching, dyspnea, chills, myalgia, headache, vomiting, glandular enlargement.

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