HES in neonatology

[Darya]

:)Good evening !

I wonder about HES in neonatology. Does anybody use hydroxyethylstarch as volumexpander in your practice? What is your opinion about it? Do you know studies about advantages or disadvantages of HES?

[ammar]

Hi Darya.

there is very interesting papers in PUBMED. but absolute conclusion is not possible now because very side effects are thinked to be just for physiologic studies and not real human studies.

However it is greatly and wide admitted that the safe volume expander in human, particulary in neonates remains physiologic solution.

[Stefan Johansson]

ammar, do you have the link to the abstract in PubMed?

[ammar]

There many papers about this. for our interst i give to you exemples to neonatal experience:

*Plasma volume expansion by medium molecular weight hydroxyethyl starch in neonates: a pilot study.

Pediatr Crit Care Med. 2003 Jul;4(3):305-7.

* Hydroxyethyl starch 130/0.42/6:1 for perioperative plasma volume replacement in children: preliminary results of a European prospective multicenter observational postauthorization safety study (PASS).

Paediatr Anaesth. 2008 Jul 21.

And for physiopathological aspects:

* Effects of whole blood, crystalloid, and colloid resuscitation of hemorrhagic shock on renal damage in rats: an ultrastructural study.

J Pediatr Surg. 2003 Nov;38(11):1642-9.

[JACK]

I will add to the link collection

Liet JM, Kuster A, Denizot S, Caillaux-Varin G, Gras-Leguen C, Rozé JC.

Effects of hydroxyethyl starch on cardiac output in hypotensive neonates: a comparison with isotonic saline and 5% albumin.

Acta Paediatr. 2006 May;95(5):555-60.

LINK

[Darya]

Thank you very much!

However, as I see, nobody has own experience in using HES?

[Stefan Johansson]

Nope.

[JACK]

None whatsoever!!!!

We use Normal Saline....sometimes FFP (Fresh frozen Plasma)......and on special occasions Packed RBCs....for all our neonatal volume expansion depending on the case.

Never ventured far to reach HES :-)

[ammar]

Darya,

we used it for 2 years for children's with septic shock. but not in neonate, we use Noraml Saline.