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Hetastarch


Presentation

  • Either hetastarch, when present at concentrations comparable to the manufacturer's maximum recommended dose of 20 mL/kg (equivalent to the high dilution used in these experiments), decreases clot tensile strength to levels associated with an increased[ncbi.nlm.nih.gov]
  • If that factor was controlled for with multivariate analysis, the same trends were present, but the apparent treatment effects of HET were no longer statistically significant.[ncbi.nlm.nih.gov]
  • Presentations will also address emergency preparedness from the processing facilities perspective and response to critical reagent shortages.[celltherapysociety.org]
  • Abstract The present study examined whether hemodilution with 20% human serum albumin (HSA) or 10% hydroxyethyl starch (HES) improved the outcome from closed-head trauma (CHT) in rats.[ncbi.nlm.nih.gov]
  • Therefore, the planned sample size was not calculated using a statistical power analysis, but was regarded as sufficient to repeat the objectives of the COSMO study (2017) and satisfy the exploratory purposes of the present study.[clinicaltrials.gov]
Prolonged Bleeding
  • - affect coagulation leading to prolonged bleeding time (affect Factor VIII and von willebrand factor) - anaphylaxis - inappropriate administration may lead to vol. overload - expensive - synthetic colloid - mixture of glucose polymers (high and low molecular[quizlet.com]
Intravenous Administration
  • License Authorization Form (LAF) Required HESPAN (6% hetastarch in 0.9% sodium chloride injection) is a sterile, nonpyrogenic solution for intravenous administration.[boundtree.com]
  • Upon intravenous administration, hydroxyethyl starch colloid increases blood volume and thus improves circulation. This agent is almost exclusively excreted by the kidneys and is potentially nephrotoxic.[cancer.gov]
  • HESPAN (6% Hetastarch in 0.9% Sodium Chloride Injection), 500 mL EXCEL IV container HESPAN (6% hetastarch in 0.9% sodium chloride injection) is a sterile, nonpyrogenic solution for intravenous administration.[bbraunusa.com]
Falling
  • A fall in excess of that caused by hemodilution was demonstrated for von Willebrand factor antigen plus its associated FVIII and ristocetin cofactor activities. The partial thromboplastin time was prolonged, whereas the thrombin time was shortened.[ncbi.nlm.nih.gov]
  • […] health care professional as soon as possible: allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue bleeding or bruising breathing problems confusion, dizziness fast, irregular heartbeat feeling faint or lightheaded, falls[my.clevelandclinic.org]
  • Infusion solutions containing HES are medicines mainly used to replace lost blood volume in hypovolaemia (low blood volume caused by dehydration or blood loss) and hypovolaemic shock (a steep fall in blood pressure caused by drop in blood volume).[ema.europa.eu]
  • Situations that fall under this procedure include consideration for suspension or revocation of the marketing authorisation for a medicine, the prohibition of supply of a medicine or major changes to the marketing authorisation such as deletion of indications[ema.europa.eu]
  • Unclear trials in which the authors either did not report an allocation concealment approach at all or reported an approach that did not fall into one of the other categories.[doi.org]
Tingling
  • Possible Side Effects While Using This Medicine: Call your doctor right away if you notice any of these side effects: Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble[trihealth.adam.com]

Workup

Brain Edema
  • At 72 hours, brains were removed, and brain edema and brain tissue necrosis volume were determined.[ncbi.nlm.nih.gov]

Treatment

  • This study shows an increase in coagulopathy with the use of hetastarch as compared with the use of PPF for the treatment of postaneurysmal vasospasm.[ncbi.nlm.nih.gov]
  • If that factor was controlled for with multivariate analysis, the same trends were present, but the apparent treatment effects of HET were no longer statistically significant.[ncbi.nlm.nih.gov]
  • Hetastarch is a plasma volume expander used in adults for the treatment of shock caused by hemorrhage, burns, surgery, sepsis, or other trauma. It is a heterogenous macromolecular agent derived from starch and is composed primarily of amylopectin.[ncbi.nlm.nih.gov]
  • The Sydney Resection Quotient will be compared between treatment groups using a Wilcoxon Rank-Sum test.[clinicaltrials.gov]
  • In addition, the LR group had a higher maximum heart rate (115 /- 17 vs 104 /- 16 bpm), a shorter mean time to hypotension (7 /- 4 vs 10 /- 7 min), and required more 5-mg doses of ephedrine for treatment of hypotension (0 vs 2 [median]; P 0.05) than the[ncbi.nlm.nih.gov]

Prognosis

  • Pathophysiology is emphasized throughout, providing a sound basis for discussions of the diagnosis, treatment, and prognosis that follow.[books.google.de]

Epidemiology

  • Elke Weisshaar and Florence Dalgard, Epidemiology, Pruritus, 10.1007/978-3-319-33142-3_9, (73-79), (2016). Jialie Luo, Jing Feng, Shenbin Liu, Edgar T.[doi.org]
  • .), Friedrich Schiller University, Jena; the Institute of Medical Informatics, Statistics and Epidemiology (C.E., M.L.) and the Coordination Center for Clinical Trials (E.K.), University of Leipzig, Leipzig; the Department of Anesthesiology and Intensive[doi.org]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology is emphasized throughout, providing a sound basis for discussions of the diagnosis, treatment, and prognosis that follow.[books.google.de]
  • The pathophysiological basis for pruritus is the widespread tissue deposition of HES, prominently in macrophages. HES tissue deposits are long lasting and sometimes massive.[ncbi.nlm.nih.gov]
  • The increase in creatinine confirmed the pathophysiological rationale. Furthermore, the patients needed more blood products, had significant more liver failure and itching. The study was published in the NEJM in October 2012..[en.wikipedia.org]
  • Br J Dermatol 2001; 144:973–6Murphy, M Carmichael, AJ Lawler, PG White, M Cox, NH Gall H, Schultz KD, Böhncke WH, Kaufmann R: Clinical and pathophysiological aspects of hydroxyethyl starch-induced pruritus: Evaluation of 96 cases.[doi.org]

Prevention

  • CONCLUSION: Hetastarch co-loading is as effective as pre-loading for the prevention of hypotension after spinal anesthesia for cesarean delivery.[ncbi.nlm.nih.gov]
  • IMPLICATIONS: This prospective, randomized, blinded trial showed that, in elderly surgical patients, the use of balanced IV solutions can prevent the development of hyperchloremic metabolic acidosis and provide better gastric mucosal perfusion compared[ncbi.nlm.nih.gov]
  • Abstract The use of colloid agents to achieve hypervolemia in the prevention and treatment of postsubarachnoid hemorrhage (post-SAH) vasospasm is included in the standard of care at many institutions.[ncbi.nlm.nih.gov]
  • Complications Associated With Artificial Fertilization / Disorder of Endocrine Ovary 1 0 Not Yet Recruiting Prevention Hypotension Drug-Induced 1 2 Completed Prevention Coagulation Defect; Bleeding 1 2 Completed Treatment Angina Pectoris / Myocardial[drugbank.ca]
  • HETASTARCH (Hespan ) treats or prevents shock, following serious injury, bleeding, surgery, or burns, by increasing the volume of blood plasma.[altonmemorialhospital.org]

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