Hydroxyethyl starch (HES) solutions are an artificial colloid useful in resuscitation in critical care. Infusion of HES may be associated a number of adverse effects. Some of the adverse effects are seen only with high doses, while some such as anaphylaxis may be seen even at low dosages.


Adverse effects associated with hydroxyethyl starch:

(1) allergic reaction

(2) anaphylactic reaction

(3) pruritis (may have a delayed onset and be difficult to treat)

(4) elevated serum amylase for several days

(5) impaired renal function

(6) coagulopathy with clinical bleeding (decreased von Willebrand's factor, thrombocytopenia, platelet dysfunction)

(7) accumulation in reticuloendothelial cells and deposits in skin, liver, muscle, spleen and other tissues

(8) increased blood viscocity with adverse rheological effects (Castro et al)


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