Controversies in the use of hydroxyethyl starch solutions in small animal emergency and critical care

Adamik, Katja; Yozova, Ivayla; Regenscheit, Nadine (2015). Controversies in the use of hydroxyethyl starch solutions in small animal emergency and critical care. Journal of veterinary emergency and critical care, 25(1), pp. 20-47. Wiley-Blackwell 10.1111/vec.12283

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OBJECTIVES: To (1) review the development and medical applications of hydroxyethyl starch (HES) solutions with particular emphasis on its physiochemical properties; (2) critically appraise the available evidence in human and veterinary medicine, and (3) evaluate the potential risks and benefits associated with their use in critically ill small animals. DATA SOURCES: Human and veterinary original research articles, scientific reviews, and textbook sources from 1950 to the present. HUMAN DATA SYNTHESIS: HES solutions have been used extensively in people for over 30 years and ever since its introduction there has been a great deal of debate over its safety and efficacy. Recently, results of seminal trials and meta-analyses showing increased risks related to kidney dysfunction and mortality in septic and critically ill patients, have led to the restriction of HES use in these patient populations by European regulatory authorities. Although the initial ban on the use of HES in Europe has been eased, proof regarding the benefits and safety profile of HES in trauma and surgical patient populations has been requested by these same European regulatory authorities. VETERINARY DATA SYNTHESIS: The veterinary literature is limited mostly to experimental studies and clinical investigations with small populations of patients with short-term end points and there is insufficient evidence to generate recommendations. CONCLUSIONS: Currently, there are no consensus recommendations regarding the use of HES in veterinary medicine. Veterinarians and institutions affected by the HES restrictions have had to critically reassess the risks and benefits related to HES usage based on the available information and sometimes adapt their procedures and policies based on their reassessment. Meanwhile, large, prospective, randomized veterinary studies evaluating HES use are needed to achieve relevant levels of evidence to enable formulation of specific veterinary guidelines.

Item Type:

Journal Article (Review Article)

Division/Institute:

05 Veterinary Medicine > Department of Clinical Veterinary Medicine (DKV)
05 Veterinary Medicine > Department of Clinical Veterinary Medicine (DKV) > Small Animal Clinic
05 Veterinary Medicine > Department of Infectious Diseases and Pathobiology (DIP) > Institute of Animal Pathology
05 Veterinary Medicine > Department of Infectious Diseases and Pathobiology (DIP)
05 Veterinary Medicine > Department of Clinical Veterinary Medicine (DKV) > Small Animal Clinic > Intensive Care Unit, Small Animal Clinic

UniBE Contributor:

Adamik, Katja; Yozova, Ivayla and Regenscheit, Nadine

Subjects:

600 Technology > 630 Agriculture
600 Technology > 610 Medicine & health

ISSN:

1479-3261

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Katja Adamik

Date Deposited:

06 Oct 2015 11:13

Last Modified:

06 Oct 2015 11:13

Publisher DOI:

10.1111/vec.12283

PubMed ID:

25655725

Uncontrolled Keywords:

colloids; hypovolemia; safety; sepsis; side effects

BORIS DOI:

10.7892/boris.72099

URI:

https://boris.unibe.ch/id/eprint/72099

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