Hetastarch
Mechanism :
Produces plasma volume expansion by virtue of its highly colloidal starch structure
Indication :
- Adjunct in leukapheresis to improve harvesting and increase the yield of granulocytes.
- Plasma volume expansion in treatment of hypovolemia.
Contraindications :
Hypersensitivity to hetastarch, hydroxyethyl starch (HES), or any component of the formulation; critically ill adults, including sepsis, severe liver disease; renal disease with oliguria or anuria (not related to hypovolemia); any fluid overload condition (e.g., pulmonary edema, heart failure); pre-existing coagulation or bleeding disorders.
Dosing :
Plasma volume expansion:
IV 500 to 1,000 mL or ~20 mL/kg once; may repeat as needed.
Granulocyte yield increase (Hespan):
250 to 700 mL.
Adverse Effect :
Bradycardia, cardiac failure, increased plasma volume, peripheral edema, tachycardia, Chills, headache, intracranial haemorrhage, hypervolemia, increased amylase, metabolic acidosis (hyperchloremic), anemia, blood coagulation disorder (Factor VIII deficiency, acquired von Willebrand’s like syndrome, dilutional coagulopathy), disseminated intravascular coagulopathy (rare), hemolysis (rare), hemorrhage, prolonged bleeding time, prolonged partial thromboplastin time, prolonged prothrombin time, thrombocytopenia, wound haemorrhage, anaphylactoid reaction, hypersensitivity, bronchospasm, flu-like symptoms (mild), non-cardiogenic pulmonary edema.
Interaction :
Arbekacin: Hetastarch may enhance the nephrotoxic effect of Arbekacin.
Hepatic Dose :
No dosage adjustments are needed.