Hetastarch Brand Name– Hespan
What is Hetastarch
Hespan injection contains hetastarch, a synthetic polymer, and is used intravenously as a colloidal plasma volume expander.
It has no oxygen-carrying capacity. HespanĀ® produces increases in circulating blood volume that are comparable to that of albumin, dextran or HextendĀ®.
Hetastarch has fewer antigenic properties than dextran. HextendĀ® has been used clinically as an adjunct in the management or prevention of shock caused by hemorrhage, burns, surgery, or trauma.
Also, it is added to whole blood to facilitate the collection of granulocytes in leukapheresis. It is commercially available as a colloidal solution. HespanĀ® contains 6% hetastarch in 0.9% sodium chloride solution.
Hetastarch is derived from a waxy starch composed almost entirely of amylopectin.
Due to a structural similarity to glycogen, hetastarch has hydroxyl ethers introduced into its glucose residues to retard degradation by serum amylase. About 75% of the glucose units are hydroxyethylated.
The average molecular weight of hetastarch is approximately 670,000; at least 80% of the polymer units have a molecular weight between 20,000 and 2,500,000.
Hetastarch was approved by the FDA in 1972.
Indications
- hypovolemia
- leukapheresis
For use as a plasma expander in cardiopulmonary bypass surgery and in the treatment of shock due to hypovolemia caused by hemorrhage, surgery, trauma, sepsis, or burns
Side Effects
- anaphylactoid reactions
- anemia
- angioedema
- bleeding
- bradycardia
- bronchospasm
- cardiac arrest
- chest pain (unspecified)
- chills
- clotting factor deficiency
- coagulopathy
- cough
- disseminated intravascular coagulation (DIC)
- dyspnea
- erythema multiforme
- fever
- flushing
- headache
- heart failure
- hemolysis
- hypotension
- intracranial bleeding
- metabolic acidosis
- myalgia
- nausea
- peripheral edema
- prolonged bleeding time
- pruritus
- pulmonary edema
- rash
- renal failure (unspecified)
- restlessness
- sinus tachycardia
- sneezing
- tachypnea
- urticaria
- ventricular fibrillation
- vomiting
- wheezing
Monitoring Parameters
- activated partial thromboplastin time (APTT)
- hemoglobin/hematocrit
- platelet count
- prothrombin time (PT)
- serum creatinine/BUN
- serum electrolytes
Contraindications
- anuria
- breast-feeding
- coagulopathy
- corn hypersensitivity
- dialysis
- heart failure
- hepatic disease
- hydroxyethyl cellulose hypersensitivity
- intracranial bleeding
- mortality
- neonates
- oliguria
- pancreatitis
- pregnancy
- pulmonary edema
- renal disease
- renal failure
- renal impairment
- sepsis
- sodium restriction
- surgery
- thrombocytopenia
- von Willebrand’s disease
Interactions
- Azelastine; Fluticasone
- Beclomethasone
- Betamethasone
- Budesonide
- Budesonide; Formoterol
- Ciclesonide
- Corticosteroids
- Cortisone
- Deflazacort
- Dexamethasone
- Dichlorphenamide
- Fludrocortisone
- Flunisolide
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Formoterol; Mometasone
- Hydrocortisone
- Lithium
- Methylprednisolone
- Mometasone
- Prednisolone
- Prednisone
- Tolvaptan
- Triamcinolone