Hetastarch (Hydroxyethyl Starch, HES)(het’ a starch)
Hespan, Voluven
PREGNANCY CATEGORY C
Drug class
Plasma expander
Therapeutic Actions
Complex mixture of various-sized molecules with colloidal properties that approximate those of human albumin and raise human plasma volume when administered IV; increases the erythrocyte sedimentation rate and improves the efficiency of granulocyte collection by centrifugal means.
Indications
Adjunctive therapy for plasma volume expansion in shock due to hemorrhage, burns, surgery, sepsis, trauma
Adjunctive therapy in leukapheresis to improve harvesting and increase the yield of granulocytes
Contraindications and Cautions
Contraindicated with allergy to hetastarch, severe bleeding disorders, severe cardiac failure, renal failure with anuria or oliguria.
Use cautiously with hepatic impairment, pregnancy, lactation.
Available Forms
Injection—6 g/100 mL in 500 mL IV infusion solution
Dosages
Adults
Plasma volume expansion: 500–1,000 mL IV. Do not usually exceed 1,500 mL/day. In acute hemorrhagic shock, rates approaching 20 mL/kg/hr are often needed (Hespan); up to 50 mL/kg/day Voluven injection.
Leukapheresis (Hespan): 250–700 mL hetastarch infused at a constant fixed ratio of 1:8 to 1:13 to venous whole blood. Safety of up to two procedures per week and a total
of seven to ten procedures using hetastarch have been established.
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