Hydroxyethyl Starch in Balanced Electrolyte Solution (Hextend®)—Pharmacokinetic and Pharmacodynamic Profiles in Healthy Volunteers

Abstract

Hextend is a new plasma volume expander containing 6% hydroxyethyl starch in a physiologically balanced medium. This open-label volunteer study demonstrated that it has pharmacokinetic and pharmacodynamic profiles similar to those of established HES.

Comparative Study Between Succinylated Gelatin (Gelofusine) Versus Ringer’s Acetate Regarding Safety and Efficacy in Adult Patients Undergoing Cardiac Surgery.

“…(9,21) Regarding 4% succinylated gelatin (the colloid of use in this study), and being a colloid of low average molecular weight, there was a believe that it escapes the capillary pores faster than that of medium and high molecular weight can do, hence, less plasma expanding effect (23) , however several studies have described gelatins and starches as equal plasma expanders both in: animal models (24)(25)(26) and human. (20,27) Moreover, in their study, Dileep et al (21) have described an equal duration of plasma expansion of both 4% succinylated gelatin (gelofusine) and 6% hydroxyethyl starch (Voluven) attributing this to the fact that hydroxyethyl starch is eliminated by the cleavage action of the serum amylase, which increased four times after infusion of hydroxyethyl starch as reported by Wilkes et al (28) The PaCO2 levels in this study were maintained by ventilation therefore, base excess (BE) and PH changes reflected any change in the non-respiratory (i.e. metabolic) state.…”

Balanced Fluid Versus Saline-Based Fluid in Post-operative Severe Traumatic Brain Injury Patients: Acid-Base and Electrolytes Assessment

“…This finding is inevitable because NS contains more chloride, which subsequently leads to this condition. According to previous studies, the balanced solution caused significant acid-base stability compared with saline-based solution in elderly surgical patients and healthy volunteers (11,13). A significant difference in bicarbonate level was found between the two groups in a 24 h period.…”

How to Maintain and Restore Fluid Balance: Colloids

“…HES are obtained by replacing the hydroxyl groups of natural starches with hydroxyethyl groups at the C2, C3, and C6 carbon positions of anhydroglucose residues. This results in greater solubility and less amylase degradation especially for hydroxyethyl groups at the C2 position [1,41].…”