Orthopaedic Jobs

Hetastarch/Hespan

 
- plasma volume expander, for treatment of shock,


- Discussion:

- synthetic colloid with actions similar to Albumin; 
- can be safelly used to a total volume of 1.5 liters; 
- its available as 6% solution in normal saline w/ osmolarity of 310 mOsm/l; 
- it generally provides plasma volume expansion for more than 24 hrs, & like dextran, can be associated w/ urticarial & anaphylactoid reactions; 
- half life for 90% of hespan particles is 17 days, whereas that of remaining 10% is 48 days; 
- Dosage: 
- usually 500-1000ml (do not usually exceed 1500ml/day) IV at a rate not to exeed 20ml/kg/hr;); 
- Precautions: 
- Not a substitute for blood or plasma; 
- Contraindicated in patients with severe bleeding disorders, severe CHF, or renal failure with oliguria or anuria; 
- Pentastarch: 
- modification of hetastarch;

- has a lower molecular wt and its particle size is more homogeneous; 
- half life 2.5 hours; 
- rapidly degraded by amylase, & vast majority is cleared in urine by 24 hrs; 
- it is available as 10% solution & has greater volume expanding ability than either 5% albumin or 6% hetastarch 


The effects of Hespan on serum and lymphatic albumin, globulin, and coagulant protein.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, April 11, 2012 3:25 pm