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Summary
Hetastarch is a cost-effective plasma volume expander for treating shock from trauma, comparable to albumin. Further studies are needed to confirm its effectiveness against other volume expanders.
Area of Science:
- Pharmacology
- Critical Care Medicine
Background:
- Hetastarch is a plasma volume expander derived from starch, primarily used in adults.
- It is indicated for treating shock resulting from hemorrhage, burns, surgery, sepsis, or trauma.
Purpose of the Study:
- To review the indications, pharmacology, adverse reactions, clinical studies, dosage, and cost of hetastarch.
- To compare hetastarch with albumin as a plasma volume expander.
Main Methods:
- Review of existing literature on hetastarch.
- Analysis of pharmacology, adverse reactions, clinical studies, dosage, and cost.
Main Results:
- Hetastarch is comparable to albumin in efficacy and is significantly cheaper.
- Recommended dosage is 500-1000 ml, not exceeding 1500 ml/day (20 ml/kg), with adjustments for renal impairment.
- Adverse reactions include minor coagulation defects at recommended doses and dose-related hematologic abnormalities with excessive infusion; elevated serum alpha-amylase and indirect bilirubin levels have also been noted.
Conclusions:
- Hetastarch is a viable, cost-effective alternative to albumin for plasma volume expansion.
- More controlled studies are required to fully evaluate hetastarch's effectiveness compared to other plasma volume expanders.