Hydroxyethyl starch - Revision history

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	~~'''Hydroxyethyl starch''' ('''HES''') is a [[starch derivative]]~~ used ~~in [[intravenous therapy]] to treat or prevent [[shock]] and [[blood volume]] deficits. It is~~ a ~~type of [[colloid]] solution, which works by increasing the~~ volume ~~of blood plasma, thereby helping to maintain blood pressure and blood flow.~~		{{Short description\|A synthetic colloid used as a plasma volume expander}}
			{{Use dmy dates\|date=October 2023}}

	~~== History ==~~		'''Hydroxyethyl starch''' (HES) is a synthetic, non-ionic starch derivative used as a [[plasma volume expander]]. It is commonly used in [[intravenous therapy]] to treat or prevent [[hypovolemia]] when [[crystalloids]] alone are not sufficient.
	~~The use of~~ HES ~~in medical treatments dates back to the 1960s. It was initially developed~~ as a [[~~blood~~ plasma ~~substitute~~]] ~~due to its ability to expand blood volume~~. ~~Over the years, its use has expanded~~ to ~~include the treatment of various conditions related to blood volume and pressure~~.

	== Composition ==		==Structure and Composition==
	~~HES~~ is ~~a complex mixture of different molecules, all of which are derivatives of~~ [[amylopectin]], a ~~type~~ of starch~~. The~~ hydroxyethyl groups ~~in HES are responsible for its~~ solubility and stability in ~~water~~.		[[File:Hydroxyethylstärke.svg\|Hydroxyethylstärke\|thumb\|left]]
			Hydroxyethyl starch is derived from [[amylopectin]], a component of [[starch]], which is modified by the addition of hydroxyethyl groups. This modification increases the solubility and stability of the starch in solution. The degree of substitution and the pattern of hydroxyethylation affect the pharmacokinetics and pharmacodynamics of the compound.

	== ~~Uses~~ ==		==Mechanism of Action==
	HES ~~is primarily used~~ in the ~~treatment of~~ [[~~hypovolemia~~]], ~~a condition characterized by a decrease in~~ the volume ~~of blood plasma~~. It is ~~also used~~ in ~~the treatment of~~ [[shock]]~~, a life-threatening condition that occurs when the body is not getting enough blood flow~~.		HES works by increasing the [[osmotic pressure]] in the blood vessels, which helps to draw fluid into the [[intravascular space]], thereby expanding the plasma volume. This is particularly useful in situations where rapid volume expansion is necessary, such as in [[shock]] or [[sepsis]].

	~~In addition to these uses, HES~~ is ~~sometimes~~ used in [[~~surgery~~]] ~~to prevent~~ blood ~~loss~~. ~~It is also used~~ in ~~the treatment of~~ [[~~burns~~]] ~~to replace lost fluids~~ and ~~maintain blood pressure~~.		==Clinical Uses==
			Hydroxyethyl starch is used in various clinical settings, including:
			* [[Surgery]]: To maintain adequate blood volume during and after surgery.
			* [[Trauma]]: As part of the resuscitation fluids in trauma patients.
			* [[Sepsis]]: To manage severe sepsis and septic shock.

	== ~~Side~~ Effects ==		==Adverse Effects==
	~~Like all medications,~~ HES ~~can cause side~~ effects~~. These can include~~ [[~~allergic reactions~~]], [[~~kidney damage~~]], ~~and~~ [[~~bleeding disorders~~]]~~. The risk of side effects can be reduced by careful monitoring and adjustment of the dosage~~.		[[File:Hydroxyethylstarch_ball-and-stick.png\|Hydroxyethylstarch ball-and-stick\|thumb\|right]]
			The use of HES has been associated with several adverse effects, including:
			* [[Coagulopathy]]: HES can interfere with blood clotting mechanisms, increasing the risk of bleeding.
			* [[Renal impairment]]: There is evidence that HES can cause or worsen kidney injury, particularly in critically ill patients.
			* [[Anaphylactoid reactions]]: Although rare, some patients may experience allergic reactions to HES.

	== ~~Controversies~~ ==		==Regulatory Status==
	~~The use of HES has been controversial due~~ to concerns about ~~its~~ safety and ~~effectiveness. Some studies have suggested that it may increase~~ the ~~risk~~ of ~~kidney damage and death~~ in ~~critically ill patients~~. ~~However, other studies~~ have ~~found no such risks,~~ and ~~the issue remains a subject of ongoing debate in the medical community~~.		Due to concerns about safety, particularly regarding kidney function and bleeding risks, the use of HES has been restricted or banned in some countries. Regulatory agencies have issued warnings and guidelines to limit its use to specific patient populations.

	== ~~See Also~~ ==		==Alternatives==
	* [[~~Colloid solutions~~]]		Alternatives to HES include other colloids such as [[gelatin]] and [[albumin]], as well as crystalloids like [[saline]] and [[Ringer's lactate]]. The choice of fluid depends on the clinical scenario and patient-specific factors.

			==Related Pages==
	* [[Intravenous therapy]]		* [[Intravenous therapy]]
			* [[Colloid]]
			* [[Crystalloid]]
	* [[Hypovolemia]]		* [[Hypovolemia]]
	* [[~~Shock~~ (~~circulatory~~)]]		* [[Sepsis]]

			[[File:Hydroxyethyl_starch_(HES-HAES).jpg\|Hydroxyethyl starch (HES-HAES)\|thumb\|left]]

	[[Category:~~Pharmacology~~]]		[[Category:Intravenous fluids]]
	[[Category:~~Medicine~~]]		[[Category:Starch derivatives]]
	[[Category:~~Health~~]]		[[Category:Plasma volume expanders]]
	~~{{Pharma-stub}}~~
	~~{{Medicine-stub}}~~
	~~<gallery>~~
	~~File:Hydroxyethyl_starch_(HES-HAES).jpg~~
	~~</gallery>~~
	~~<gallery>~~
	~~File:Hydroxyethylstärke.svg\|Hydroxyethylstärke~~
	~~File:Hydroxyethylstarch_ball-and-stick.png\|Hydroxyethylstarch ball-and-stick~~
	~~File:Hydroxyethyl_starch_(HES-HAES).jpg\|Hydroxyethyl starch (HES-HAES)~~
	~~</gallery>~~

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	<gallery>		<gallery>
	File:Hydroxyethyl_starch_(HES-HAES).jpg		File:Hydroxyethyl_starch_(HES-HAES).jpg
			</gallery>
			<gallery>
			File:Hydroxyethylstärke.svg\|Hydroxyethylstärke
			File:Hydroxyethylstarch_ball-and-stick.png\|Hydroxyethylstarch ball-and-stick
			File:Hydroxyethyl_starch_(HES-HAES).jpg\|Hydroxyethyl starch (HES-HAES)
	</gallery>		</gallery>

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	{{Pharma-stub}}		{{Pharma-stub}}
	{{Medicine-stub}}		{{Medicine-stub}}
			<gallery>
			File:Hydroxyethyl_starch_(HES-HAES).jpg
			</gallery>

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New page

'''Hydroxyethyl starch''' ('''HES''') is a [[starch derivative]] used in [[intravenous therapy]] to treat or prevent [[shock]] and [[blood volume]] deficits. It is a type of [[colloid]] solution, which works by increasing the volume of blood plasma, thereby helping to maintain blood pressure and blood flow.

== History ==
The use of HES in medical treatments dates back to the 1960s. It was initially developed as a [[blood plasma substitute]] due to its ability to expand blood volume. Over the years, its use has expanded to include the treatment of various conditions related to blood volume and pressure.

== Composition ==
HES is a complex mixture of different molecules, all of which are derivatives of [[amylopectin]], a type of starch. The hydroxyethyl groups in HES are responsible for its solubility and stability in water.

== Uses ==
HES is primarily used in the treatment of [[hypovolemia]], a condition characterized by a decrease in the volume of blood plasma. It is also used in the treatment of [[shock]], a life-threatening condition that occurs when the body is not getting enough blood flow.

In addition to these uses, HES is sometimes used in [[surgery]] to prevent blood loss. It is also used in the treatment of [[burns]] to replace lost fluids and maintain blood pressure.

== Side Effects ==
Like all medications, HES can cause side effects. These can include [[allergic reactions]], [[kidney damage]], and [[bleeding disorders]]. The risk of side effects can be reduced by careful monitoring and adjustment of the dosage.

== Controversies ==
The use of HES has been controversial due to concerns about its safety and effectiveness. Some studies have suggested that it may increase the risk of kidney damage and death in critically ill patients. However, other studies have found no such risks, and the issue remains a subject of ongoing debate in the medical community.

== See Also ==
* [[Colloid solutions]]
* [[Intravenous therapy]]
* [[Hypovolemia]]
* [[Shock (circulatory)]]

[[Category:Pharmacology]]
[[Category:Medicine]]
[[Category:Health]]
{{Pharma-stub}}
{{Medicine-stub}}