Hydroxyethyl Starch

Definition

Hydroxyethyl starch (HES) is a synthetic colloid solution used as an intravenous fluid therapy, in total parenteral nutrition, and as a blood product. It is derived from natural starch and is designed to mimic the properties of natural plasma proteins, serving as a volume expander and plasma substitute.

5 Must Know Facts For Your Next Test

1. Hydroxyethyl starch is used as a volume expander to treat hypovolemia, shock, and other conditions requiring fluid resuscitation.
2. HES solutions can be used as an alternative to albumin or other colloid solutions in intravenous fluid therapy.
3. In total parenteral nutrition, HES may be used as a calorie-free volume expander to maintain fluid balance.
4. Hydroxyethyl starch can be used as a blood product substitute, as it has similar oncotic properties to natural plasma proteins.
5. The molecular weight and degree of hydroxyethylation of HES can affect its pharmacokinetics and clinical efficacy.

Review Questions

• Explain how hydroxyethyl starch functions as an intravenous fluid therapy and its role in maintaining fluid balance.
  • Hydroxyethyl starch is used as a colloid solution in intravenous fluid therapy to expand the plasma volume and maintain fluid balance in the body. As a synthetic plasma expander, HES helps to draw water into the intravascular space, increasing blood volume and preventing or treating hypovolemia. This can be particularly useful in situations of fluid loss, such as hemorrhage or dehydration, where HES can help restore and maintain adequate circulatory volume.
• Describe the use of hydroxyethyl starch in the context of total parenteral nutrition and its advantages over other fluid components.
  • In total parenteral nutrition (TPN), hydroxyethyl starch can be used as a calorie-free volume expander to help maintain fluid balance. Unlike other TPN components that provide calories, such as glucose or lipids, HES is a non-nutritive colloid that can help regulate fluid status without contributing additional energy. This can be beneficial in situations where caloric intake needs to be carefully controlled, such as in critically ill patients or those with certain metabolic disorders. The use of HES in TPN allows for the adjustment of fluid levels without significantly altering the overall nutritional composition of the parenteral formula.
• Analyze the use of hydroxyethyl starch as a blood product substitute and its advantages over natural plasma proteins.
  • Hydroxyethyl starch can be used as a blood product substitute due to its similar oncotic properties to natural plasma proteins. HES solutions can help maintain intravascular volume and colloid osmotic pressure, making them useful in situations where blood products may not be available or appropriate, such as in certain religious or cultural beliefs that restrict the use of blood-derived products. Additionally, the synthetic nature of HES eliminates the risk of transmission of blood-borne pathogens that can occur with natural blood products. However, the use of HES as a blood product substitute is not without potential risks, and its safety and efficacy compared to natural plasma proteins must be carefully considered in each clinical scenario.

Related terms

Colloid: A type of solution where larger molecules, such as proteins, are suspended in a liquid medium, as opposed to a true solution of smaller molecules.

Plasma Expander: A substance used to increase the volume of blood plasma, often used to treat hypovolemia or shock.

Hemodilution: The dilution of blood, usually by the addition of fluids, resulting in a decrease in the concentration of red blood cells and other blood components.