Hetastarch – Part 2
The most common indication for use of hetastarch (hydroxyethyl starch) is as volume-expanding fluid in sepsis, systemic inflammatory response syndrome (SIRS), hemorrhage, and burns. It causes an osmotic diuresis (makes the kidneys produce urine) after administration so an increased urine output should not be taken that adequate fluid resuscitation has occurred.
Hetastarch is eliminated through both the kidneys and the liver. In patients with renal (kidney) impairment, repeated doses of hetastarch should be avoided as total body accumulation will occur causing volume overload. In these patients, alternate fluids to be considered include hypertonic saline and crystalloid.
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