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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.