This is the need-to-know information about Hextend:


Pearls and fun nuggets

1. Hextend may not be that great of a resuscitation fluid for sepsis šŸ˜ In June 2012 a 6S paper was published in the New England Journal of MedicineĀ raising concerns regarding the use of hydroxyethyl starch inĀ sepsis. Specifically, the authors showed that resuscitation with hydroxyethyl starch (as opposed toĀ Ringer’s acetate) resulted in an increased risk of death or end stage renal failure.[13]

2. It may also be bad for hemorrhagic shock šŸ˜„ Hextend is linked to a decrease in hematocritĀ and disturbances inĀ blood clotting. One liter of 6% solution (Hespan) reducesĀ factor VIIIĀ level by 50% and will prolong theĀ aPTTĀ and will also decrease vWF.Ā [5]Ā A coagulation effect of hetastarch administration is direct movement into fibrin clots and a dilutional effect on serum.

3. Where does your body put all that Hextend? šŸ˜³ Approximately one-third to two-thirds of administered HES cannot be accounted for by 24-h urinary excretion. In one study the cumulative excretion over 72 h was 50% of the administered dose. HES has remained detectable in plasma 4 months after infusion, and in skin tissue up to 54 months after HES infusion. Administered HES accumulates in large quantities within diverse tissues where it can persist for periods of several years.[20]Ā Therefore, HES should not be administered for longer than 24 hours.[21]

Brandon Simpson, PA-C
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