[Hydroxyethyl starch].
OBJECTIVE
The purpose of this review is to draw up a statement on current knowledge available on the more recent hydroxyethyl starch (HES).


METHODS
References were obtained from computerized bibliographic research (Medline), recent review articles, the library of the service and personal files.


METHODS
All categories of articles on this topic have been selected.


METHODS
Articles have been analysed for biophysics, pharmacology, toxicity, side effects, clinical effects and using prospect of HES.


RESULTS
The first HES was made available in the United States in 1970. The development of a new generation of HES restarted the discussion on clinical interest and the limits in the use of these macromolecules. This interest is also strengthened today by the recent data attached to plasma substitution in intensive care or perioperative resuscitation. The interest for crystalloids and colloids is still widely debated, and among the latter, the relative interest of the HES last generation compared to older ones. Recent HES development is in line with a decrease molecular weight, change rate molar substitution and to amend the glucose to hydroxyethyl report. The ultimate goal is to reduce the side effects of these molecules preventing their use. Side effects are dominated by haemostasis and renal dysfunction. The latest developments are the so-called HES "balanced" solutions.
Wierre
F
F
Pôle d'anesthésie-réanimation, hôpital Huriez, CHRU de Lille, rue Polonovski, 59037 Lille cedex, France.
Robin
E
E
Barreau
O
O
Vallet
B
B
D001777:Blood Coagulation / Q000187:drug effects; D003422:Critical Care; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000009:adverse effects / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use* / Q000633:toxicity; D007674:Kidney Diseases / Q000139:chemically induced; D008970:Molecular Weight; D019999:Pharmaceutical Solutions; D010952:Plasma Substitutes / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use* / Q000633:toxicity; D010953:Plasma Volume
D006895:Hydroxyethyl Starch Derivatives; D019999:Pharmaceutical Solutions; D010952:Plasma Substitutes