What is Hetastarch-Sodium Chloride: Uses, Dosage, Side Effects and More

Hetastarch-sodium chloride is a medical solution given through an IV to help restore blood volume when your body has lost too much fluid. This medication combines hetastarch, a synthetic plasma expander, with sodium chloride (salt water) to create a solution that stays in your blood vessels longer than regular saline.

Healthcare providers typically use this medication in hospitals during emergencies, surgeries, or when patients have severe fluid loss from conditions like bleeding or shock. It acts as a temporary substitute for lost blood volume while your body recovers or receives additional treatment.

What is Hetastarch-Sodium Chloride?

Hetastarch-sodium chloride is a clear, sterile solution that contains two main components working together. The hetastarch part is a large molecule made from starch that acts like a sponge in your bloodstream, helping to pull fluid back into your blood vessels and keep it there.

The sodium chloride component provides essential salts your body needs to function properly. When combined, these ingredients create what doctors call a "plasma volume expander" because it increases the amount of fluid circulating in your blood vessels.

This medication belongs to a class of drugs called colloids, which are different from simple salt water solutions. Unlike regular IV fluids that quickly leave your bloodstream, hetastarch-sodium chloride stays in your circulation for several hours, making it more effective for certain medical situations.

What is Hetastarch-Sodium Chloride Used For?

Doctors primarily use hetastarch-sodium chloride to treat hypovolemia, which means your body doesn't have enough fluid in your blood vessels. This can happen during major surgery, severe bleeding, burns, or other conditions where you lose significant amounts of blood or fluid.

The medication helps restore your blood pressure and ensures your organs receive adequate blood flow. It's particularly useful when patients need immediate volume replacement but blood products aren't immediately available or appropriate.

Here are the main situations where healthcare providers might use this medication:

• Emergency treatment of shock from blood loss
• During major surgical procedures to maintain blood pressure
• Severe dehydration that doesn't respond to regular IV fluids
• Burns covering large areas of the body
• Certain kidney procedures where blood flow needs support

Your medical team will carefully evaluate whether this medication is right for your specific situation. They consider factors like your overall health, kidney function, and the severity of your condition.

How Does Hetastarch-Sodium Chloride Work?

Hetastarch-sodium chloride works by increasing the amount of fluid in your blood vessels and helping that fluid stay there longer. The hetastarch molecules are too large to easily pass through the walls of your blood vessels, so they create what doctors call "oncotic pressure."

This pressure acts like a magnet, pulling fluid from your tissues back into your bloodstream and preventing it from leaking out. Think of it as giving your blood vessels more staying power to hold onto the fluid they need.

The medication is considered moderately strong compared to other IV fluids. While regular saline solutions work quickly but don't last long, hetastarch-sodium chloride provides longer-lasting volume support. However, it's not as powerful as some other plasma expanders, making it a middle-ground option for many situations.

Your body gradually breaks down the hetastarch molecules over several hours to days. Your kidneys filter out the smaller pieces, while larger molecules may stay in your system longer before being eliminated.

How Should I Take Hetastarch-Sodium Chloride?

You won't take hetastarch-sodium chloride yourself because it's only given by healthcare professionals through an IV in a hospital or clinical setting. Your medical team will insert a thin tube into one of your veins and slowly infuse the medication directly into your bloodstream.

The rate of infusion depends on your specific medical condition and how quickly you need volume replacement. Your healthcare providers will monitor you closely during the entire process, checking your blood pressure, heart rate, and other vital signs.

Since this medication is given in medical facilities, you don't need to worry about taking it with food or water. However, your healthcare team might adjust your regular medications or eating schedule based on your overall treatment plan.

The medical staff will also monitor your fluid balance carefully to ensure you're receiving the right amount. They may check your blood work periodically to make sure your body is responding well to the treatment.

How Long Should I Take Hetastarch-Sodium Chloride For?

Hetastarch-sodium chloride is typically used for short periods, usually just during the immediate crisis or medical procedure. Most patients receive it for hours to a few days, depending on how quickly their condition improves.

Your healthcare team will stop the medication once your blood volume has stabilized and your body can maintain proper fluid levels on its own. They might switch you to other types of IV fluids or oral medications as you recover.

The duration depends on several factors including the severity of your condition, how well you respond to treatment, and whether you develop any side effects. Your medical team continuously evaluates whether you still need this medication.

Some patients might need repeated doses if they experience ongoing fluid loss, but doctors try to limit the total amount you receive to reduce the risk of side effects.

What Are the Side Effects of Hetastarch-Sodium Chloride?

Like all medications, hetastarch-sodium chloride can cause side effects, though many people tolerate it well when used appropriately. Your healthcare team will monitor you closely for any reactions during and after treatment.

The most common side effects are generally mild and often related to the IV infusion process itself. These typically resolve quickly and don't require stopping the medication.

Common side effects you might experience include:

• Mild itching or skin irritation
• Slight swelling at the IV site
• Temporary changes in blood pressure
• Mild headache
• Feeling of fullness or bloating

More serious but less common side effects can occur, especially with larger doses or prolonged use. Your medical team watches for these carefully and will take immediate action if they occur.

Serious side effects that require immediate medical attention include:

• Severe allergic reactions with difficulty breathing or swelling
• Significant changes in heart rhythm
• Excessive fluid buildup in the lungs
• Bleeding problems or unusual bruising
• Severe kidney problems

There are also some rare but important side effects that can develop over time. These are more likely to occur with higher doses or repeated use of the medication.

Rare complications may include:

• Interference with blood clotting mechanisms
• Accumulation of hetastarch in tissues
• Severe itching that persists for weeks or months
• Kidney damage in susceptible individuals
• Interference with certain blood tests

Your healthcare providers carefully weigh these risks against the benefits of using this medication for your specific situation. They'll discuss any concerns with you and adjust your treatment plan if needed.

Who Should Not Take Hetastarch-Sodium Chloride?

Certain people should not receive hetastarch-sodium chloride because it could worsen their condition or cause dangerous side effects. Your medical team will review your medical history carefully before using this medication.

People with severe kidney disease may not be able to process this medication properly, leading to accumulation in the body. Similarly, those with severe heart failure might not be able to handle the additional fluid volume.

Conditions that typically prevent the use of hetastarch-sodium chloride include:

• Severe kidney disease or kidney failure
• Severe heart failure with fluid overload
• Known allergy to hetastarch or corn-derived products
• Severe bleeding disorders
• Severe liver disease
• Intracranial bleeding

Your healthcare team will also use extra caution if you have certain other conditions. They may still use the medication but with closer monitoring and possibly modified dosing.

Conditions requiring careful consideration include:

• Mild to moderate kidney problems
• History of allergic reactions to IV medications
• Pregnancy or breastfeeding
• Elderly age (over 65)
• Previous surgery or medical procedures
• Taking blood-thinning medications

If you have any of these conditions, your medical team will carefully evaluate whether the benefits outweigh the risks in your specific situation.

Hetastarch-Sodium Chloride Brand Names

Hetastarch-sodium chloride is available under several brand names, though the generic version is commonly used in many hospitals. The most widely recognized brand name is Hespan, which has been used for many years.

Other brand names you might encounter include Hextend, though this formulation contains additional ingredients like calcium and magnesium. Your healthcare team will choose the most appropriate version based on your specific medical needs.

Some hospitals may use generic versions of hetastarch-sodium chloride that don't carry a specific brand name. These generic versions contain the same active ingredients and work just as effectively as the branded versions.

Hetastarch-Sodium Chloride Alternatives

Several alternative medications can provide similar volume expansion effects when hetastarch-sodium chloride isn't suitable or available. Your healthcare team will choose the best option based on your specific medical situation and needs.

Albumin is often considered the gold standard for volume expansion, though it's more expensive and derived from human blood products. It works similarly to hetastarch but has a different side effect profile.

Other alternatives your medical team might consider include:

• Human albumin solutions
• Other synthetic colloids like dextran
• Crystalloid solutions like normal saline or lactated Ringer's
• Gelatin-based plasma expanders
• Fresh frozen plasma in certain situations

The choice of alternative depends on factors like your medical condition, availability of the product, cost considerations, and your individual risk factors. Your healthcare team will make the best decision for your specific situation.

Is Hetastarch-Sodium Chloride Better Than Albumin?

Hetastarch-sodium chloride and albumin both work as volume expanders, but they have different advantages and disadvantages. Neither is universally better than the other; the choice depends on your specific medical situation.

Hetastarch-sodium chloride is generally less expensive and more readily available than albumin. It also provides effective volume expansion and stays in your bloodstream for several hours, making it useful for many emergency situations.

However, albumin is derived from human blood and is considered more "natural" to your body. It may be preferred in certain situations, especially when you need longer-lasting volume support or have specific medical conditions that make hetastarch less suitable.

Your healthcare team considers several factors when choosing between these medications, including your kidney function, bleeding risk, cost considerations, and the specific medical emergency you're facing.