To use or not to use hydroxyethyl starch in intraoperative care

Heler, Michael; Arnemann, Philip-Helge; Ertmer, Christian

doi:10.1097/aco.0000000000000194

Cited by 12 publications

(9 citation statements)

References 73 publications

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“…In a recent Cochrane Review, it was suggested that HES increase the risk for AKI in all patient populations . Yet recent meta‐analyses demonstrate no increased risk of AKI or death in surgical patients . Differences between elective surgical and critically ill or septic patients include physiological–pharmacological (different aspects of Starling's equation, predisposition of AKI through primary disease state) and therapeutic (treatment duration and cumulative dose) parameters, and can explain their divergent outcomes.…”

Section: Indications Considerations and Recommendations For The Usementioning

confidence: 99%

“…16 Yet recent meta-analyses demonstrate no increased risk of AKI or death in surgical patients. [125][126][127][128][129][130] Differences between elective surgical and critically ill or septic patients include physiological-pharmacological (different aspects of Starling's equation, predisposition of AKI through primary disease state) and therapeutic (treatment duration and cumulative dose) parameters, and can explain their divergent outcomes. It appears that people undergoing major gastrointestinal surgery benefit most from HES over crystalloids.…”

Section: Perioperative Fluid Challengementioning

confidence: 99%

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Hydroxyethyl starches in equine medicine

Galen

Hallowell

2019

J Vet Emergen Crit Care

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Objective To review and discuss the use of hydroxyethyl starches (HES) in equine veterinary medicine, and to provide recommendations for its use. Data sources Veterinary and human peer‐reviewed medical literature including scientific reviews, meta‐analyses, and original research articles. Human data synthesis Increasing evidences on adverse effects after HES use and decreasing support for beneficial effects with regards to volume expansion and colloid osmotic pressure (COP) support in critically ill subjects have led to a recent guideline to limit the use of HES in critically ill people. Equine veterinary data synthesis The rationale for HES use in horses is mainly extrapolated from human medicine, and very limited studies in horses are available. There is limited evidence suggesting a superiority of volume expansion effects of HES over crystalloids. The potential for HES to increase and maintain COP is well supported, but there is no evidence that maintaining or increasing plasma COP influences outcome, tissue edema formation, or rates of complications that potentially relate to edema formation. HES induce dose–dependent changes in coagulopathic parameters, but there is no evidence that HES causes clinical coagulopathies. Insufficient data are available on other adverse effects such as acute kidney injury, or mortality in horses. The use of HES should be restricted in septic patients, but may still have some use in cases of hemorrhagic shock resuscitation, hypoalbuminemia, or perioperative fluid replacement. Conclusion The evidence supporting the use of HES in horses is weak due to lack of species‐specific investigations. Acknowledging species differences, the use of HES should be judicious, yet with some recognition of its benefits in particular cases. More research is necessary to improve knowledge on use of HES in horses and to establish better future recommendations.

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Section: Indications Considerations and Recommendations For The Usementioning

confidence: 99%

Section: Perioperative Fluid Challengementioning

confidence: 99%

Hydroxyethyl starches in equine medicine

Galen

Hallowell

2019

J Vet Emergen Crit Care

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“…Unlike critically ill or septic patients [4,5], several investigators have reported that HES can be used safely for fluid therapy in patients undergoing elective non-cardiac surgery [6][7][8], which is why we used it for total hip replacement patients in our study.…”

Section: Tranexamic Acid Hip Replacement and Starchmentioning

confidence: 99%

“…We excluded any disease affecting haemostasis, including patients with aplastic anaemia, multiple myeloma, thrombocytopaenia and renal disease [6,[8][9][10].…”

Section: Tranexamic Acid Hip Replacement and Starchmentioning

confidence: 99%

Tranexamic acid, hip replacement and starch

McClelland

2016

Anaesthesia

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“…Currently, the safety of using of HES in major orthopedic surgery remains uncertain. Unlike critically ill or septic patients , several investigators have reported that HES can be used safely for fluid therapy in patients undergoing elective non‐cardiac surgery , which is why we used it for total hip replacement patients in our study.…”

mentioning

confidence: 99%