Impact of hydroxyethyl starch on renal function

Abstract

Adequate volume replacement to restore and maintain circulating plasma volume appears to be fundamental to improve organ perfusion and nutritive microcirculatory flow in critically ill patients [1]. A variety of pharmaceutical preparations are available that can be used to replace or compensate for lost extracellular fluids in different clinical settings, including colloid and crystalloid solutions. Circulatory stability following fluid resuscitation is usually achieved at the expense of tissue edema formation, which may significantly influence vital organ function. The question of which type of solution should be used as volume replacement remains controversial [2]. Clinically, colloids are frequently used for volume replacement when attempting to maintain or improve tissue perfusion in patients experiencing infection, sepsis, trauma, shock, or surgical stress [3]. Compared to crystalloids, colloids have the advantage of maintenance of an increased colloid osmotic pressure (COP). Thus, fluid is retained in the intravascular space, even in the presence of increased permeability, thereby minimizing edema formation and improving oxygen delivery and organ function [4, 5]. © 2009 Springer-Verlag New York.