Hydroxyethyl starch

Hydroxyethyl starch
Clinical data
Trade names	Hespan, Voluven, Volulyte, Tetrahes, Hestar
Routes of; administration	Intravenous
ATC code	B05AA07 (WHO) ;
Pharmacokinetic data
Elimination half-life	1.4 hrs
Excretion	Renal
Identifiers
CAS Number	9005-27-0 ;
ChemSpider	17340832 ;
UNII	875Y4127EA;
CompTox Dashboard (EPA)	DTXSID3046829 ;
ECHA InfoCard	100.120.749
Chemical and physical data
Molar mass	130–200 kg/mol (typical)
3D model (JSmol)	Interactive image;
	SMILES O(CCO)[C@H]1O[C@@H]([C@@H](OCCO)[C@H](OCCO)[C@H]1OCCO)COCCO.OC[C@H]1O[C@H](O)[C@H](O)[C@@H](O)[C@@H]1O;
	InChI InChI=1S/C16H32O11.C6H12O6/c17-1-6-22-11-12-13(23-7-2-18)14(24-8-3-19)15(25-9-4-20)16(27-12)26-10-5-21;7-1-2-3(8)4(9)5(10)6(11)12-2/h12-21H,1-11H2;2-11H,1H2/t12-,13-,14+,15-,16+;2-,3-,4+,5-,6+/m11/s1 ; Key:DNZMDASEFMLYBU-RNBXVSKKSA-N ;
	(verify)

Hydroxyethyl starch (HES/HAES), sold under the brand name Voluven among others, is a nonionic starch derivative, used as a volume expander in intravenous therapy. The use of HES on critically ill patients is associated with an increased risk of death and kidney problems.^[1]^[2]

HES is a general term and can be sub-classified according to average molecular weight, molar substitution, concentration, C2/C6 ratio and Maximum Daily Dose.^[3] The European Medicines Agency commenced in June 2013 the process of agreeing to reduced indications which was completed in October 2013.^[4] The process of full withdrawal in the EU was expected to complete in 2018.

^ Zarychanski R, Abou-Setta AM, Turgeon AF, Houston BL, McIntyre L, Marshall JC, et al. (February 2013). "Association of hydroxyethyl starch administration with mortality and acute kidney injury in critically ill patients requiring volume resuscitation: a systematic review and meta-analysis". JAMA. 309 (7): 678–688. doi:10.1001/jama.2013.430. PMID 23423413.
^ Mishler J (1982). Pharmacology of Hydroxyethyl Starch. Use in Therapy and Blood Banking (First ed.). Oxford London Toronto: Oxford University Press. p. 207. ISBN 0-19-261239-5.
^ Westphal M, James MF, Kozek-Langenecker S, Stocker R, Guidet B, Van Aken H (July 2009). "Hydroxyethyl starches: different products--different effects". Anesthesiology. 111 (1): 187–202. doi:10.1097/aln.0b013e3181a7ec82. PMID 19512862.
^ "Hydroxyethyl-starch solutions (HES) should no longer be used in patients with sepsis or burn injuries or in critically ill patients" (Press release). European Medicines Agency. 23 October 2013.

[Zar2013-1] Zarychanski R, Abou-Setta AM, Turgeon AF, Houston BL, McIntyre L, Marshall JC, et al. (February 2013). "Association of hydroxyethyl starch administration with mortality and acute kidney injury in critically ill patients requiring volume resuscitation: a systematic review and meta-analysis". JAMA. 309 (7): 678–688. doi:10.1001/jama.2013.430. PMID 23423413.

[2] Mishler J (1982). Pharmacology of Hydroxyethyl Starch. Use in Therapy and Blood Banking (First ed.). Oxford London Toronto: Oxford University Press. p. 207. ISBN 0-19-261239-5.

[Westphal,_M._2009-3] Westphal M, James MF, Kozek-Langenecker S, Stocker R, Guidet B, Van Aken H (July 2009). "Hydroxyethyl starches: different products--different effects". Anesthesiology. 111 (1): 187–202. doi:10.1097/aln.0b013e3181a7ec82. PMID 19512862.

[EMEAOCT-4] "Hydroxyethyl-starch solutions (HES) should no longer be used in patients with sepsis or burn injuries or in critically ill patients" (Press release). European Medicines Agency. 23 October 2013.

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