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Hetastarch: platelet function

Hydroxyethyl starch (hetastarch) is a colloid solution available in the United States as a 6% solution in 0.9% NaCl (Hespan), as well as Hextend. The larger molecules (the range is from 10,000 to 2 million daltons) of Hespan are degraded by amylase. Hydroxyethyl starch is stored in the reticuloendothelial system for hours and is thought to be renally excreted.

Its coagulation effects include a dilutional effect, reduction in factor VIII and vWF levels, reduction in glycoprotein IIb/IIIa availability (interferes with platelet adhesion), and direct movement into fibrin clots.

Allergic reactions and bleeding have been described with doses of 20 mL/kg or higher

Hextend is another hydroxyethyl with smaller units, which may not affect coagulation as much as as Hespan

Coagulation Effects of Hydroxyethyl starch

  • Dilution
  • Reduction in factor VIII and vWF levels
  • Reduction in glycoprotein IIb/IIIa availability
  • Direct movement into fibrin clots

Other References

  1. Keys to the Cart: December 18, 2017; A 5-minute video review of ABA Keywords Link