Does Voluven (hydroxyethyl starch 130/0.4) cause less bleeding than hetastarch?
Hydroxyethyl starch (HES) refers to a class of synthetic colloid solutions that are similar to glycogen.1-3 Starches were developed in response to the need for a synthetic colloid with less immunogenic potential than dextran.1 Hetastarch (Hespan, hydroxyethyl starch in saline), the most common agent in this class, is derived from corn starch and has a molecular weight of 600,000 daltons. Hydroxyethyl starch 6% is also commercially available in a balanced electrolyte solution (Hextend) with a molecular weight of 670, 000 daltons.4 In January 2008 a new lower substituted and lower molecular weight (130,00 daltons) hydroxyethyl starch in saline formulation (130/0.4, Voluven) was approved for use in the United States.5 Hydroxyethyl starch preparations are efficient volume expanders used primarily for the treatment of hypovolemia; however, their use is associated with significant adverse effects.6 The main safety concerns include coagulation abnormalities, renal failure, and refractory prur
