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.
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 ExpansionAdults
IV 500 to 1,000 mL/day; dosage does not usually exceed 1,500 mL/day.
LeukapheresisAdults
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.
Copyright © 2009 Wolters Kluwer Health.
