Infusionstherapie und klinische Ernährung
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Infusionsther Klin Ernahr · Jun 1978
[Blood volume replacement and hemodilution with hydroxyethyl starch].
For high molecular hydroxyethylstarch (MW 450000, DS 0.7-0.8) an adequate volume effect has been demonstrated in numerous experimental and clinical studies; this colloid is, therefore, suitable for primary volume replacement as well as for preoperative normovolemic hemodilution. In contrast to colloids hitherto known HES infusion results in hyperamylasemia of probably non-pathogenic importance but significance for differential diagnosis in the post-operative period. Anaphylactoid reactions to HES are infrequent (0.08%). ⋯ The elimination of HES from the circulation follows a protracted course, therefore accumulation of HES in tissues may occur after repeated infusions presenting a clear disadvantage of HES. There is, however, evidence that starch-preparations will be available in the future presenting an adequate volume effect while the elimination from the organism occurs rapidly. Low molecular hydroxyethylstarch (HES 450000, DS 0.5-0.55) yields inadequate volume effects; for this, low molecular HES can neither be recommended for long-lasting volume replacement nor for preoperative hemodilution.