Tags

Type your tag names separated by a space and hit enter

Hydroxyethyl starches in equine medicine.

Abstract

OBJECTIVE

To review and discuss the use of hydroxyethyl starches (HES) in equine veterinary medicine, and to provide recommendations for its use.

DATA SOURCES

Veterinary and human peer-reviewed medical literature including scientific reviews, meta-analyses, and original research articles.

HUMAN DATA SYNTHESIS

Increasing evidences on adverse effects after HES use and decreasing support for beneficial effects with regards to volume expansion and colloid osmotic pressure (COP) support in critically ill subjects have led to a recent guideline to limit the use of HES in critically ill people.

EQUINE VETERINARY DATA SYNTHESIS

The rationale for HES use in horses is mainly extrapolated from human medicine, and very limited studies in horses are available. There is limited evidence suggesting a superiority of volume expansion effects of HES over crystalloids. The potential for HES to increase and maintain COP is well supported, but there is no evidence that maintaining or increasing plasma COP influences outcome, tissue edema formation, or rates of complications that potentially relate to edema formation. HES induce dose-dependent changes in coagulopathic parameters, but there is no evidence that HES causes clinical coagulopathies. Insufficient data are available on other adverse effects such as acute kidney injury, or mortality in horses. The use of HES should be restricted in septic patients, but may still have some use in cases of hemorrhagic shock resuscitation, hypoalbuminemia, or perioperative fluid replacement.

CONCLUSION

The evidence supporting the use of HES in horses is weak due to lack of species-specific investigations. Acknowledging species differences, the use of HES should be judicious, yet with some recognition of its benefits in particular cases. More research is necessary to improve knowledge on use of HES in horses and to establish better future recommendations.

Authors+Show Affiliations

Medicine and Surgery, Department of Large Animal Science, University of Copenhagen, Copenhagen, Denmark.School of Veterinary Medicine and Surgery, University of Nottingham, Nottingham, UK.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31228334

Citation

van Galen, Gaby, and Gayle Hallowell. "Hydroxyethyl Starches in Equine Medicine." Journal of Veterinary Emergency and Critical Care (San Antonio, Tex. : 2001), vol. 29, no. 4, 2019, pp. 349-359.
van Galen G, Hallowell G. Hydroxyethyl starches in equine medicine. J Vet Emerg Crit Care (San Antonio). 2019;29(4):349-359.
van Galen, G., & Hallowell, G. (2019). Hydroxyethyl starches in equine medicine. Journal of Veterinary Emergency and Critical Care (San Antonio, Tex. : 2001), 29(4), pp. 349-359. doi:10.1111/vec.12854.
van Galen G, Hallowell G. Hydroxyethyl Starches in Equine Medicine. J Vet Emerg Crit Care (San Antonio). 2019;29(4):349-359. PubMed PMID: 31228334.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hydroxyethyl starches in equine medicine. AU - van Galen,Gaby, AU - Hallowell,Gayle, Y1 - 2019/06/22/ PY - 2016/11/29/received PY - 2017/06/11/revised PY - 2017/07/24/accepted PY - 2019/6/23/pubmed PY - 2019/10/24/medline PY - 2019/6/23/entrez KW - HES KW - colloid KW - fluid therapy KW - horse KW - hypoalbuminemia KW - resuscitation SP - 349 EP - 359 JF - Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) JO - J Vet Emerg Crit Care (San Antonio) VL - 29 IS - 4 N2 - OBJECTIVE: To review and discuss the use of hydroxyethyl starches (HES) in equine veterinary medicine, and to provide recommendations for its use. DATA SOURCES: Veterinary and human peer-reviewed medical literature including scientific reviews, meta-analyses, and original research articles. HUMAN DATA SYNTHESIS: Increasing evidences on adverse effects after HES use and decreasing support for beneficial effects with regards to volume expansion and colloid osmotic pressure (COP) support in critically ill subjects have led to a recent guideline to limit the use of HES in critically ill people. EQUINE VETERINARY DATA SYNTHESIS: The rationale for HES use in horses is mainly extrapolated from human medicine, and very limited studies in horses are available. There is limited evidence suggesting a superiority of volume expansion effects of HES over crystalloids. The potential for HES to increase and maintain COP is well supported, but there is no evidence that maintaining or increasing plasma COP influences outcome, tissue edema formation, or rates of complications that potentially relate to edema formation. HES induce dose-dependent changes in coagulopathic parameters, but there is no evidence that HES causes clinical coagulopathies. Insufficient data are available on other adverse effects such as acute kidney injury, or mortality in horses. The use of HES should be restricted in septic patients, but may still have some use in cases of hemorrhagic shock resuscitation, hypoalbuminemia, or perioperative fluid replacement. CONCLUSION: The evidence supporting the use of HES in horses is weak due to lack of species-specific investigations. Acknowledging species differences, the use of HES should be judicious, yet with some recognition of its benefits in particular cases. More research is necessary to improve knowledge on use of HES in horses and to establish better future recommendations. SN - 1476-4431 UR - https://www.unboundmedicine.com/medline/citation/31228334/Hydroxyethyl_starches_in_equine_medicine L2 - https://doi.org/10.1111/vec.12854 DB - PRIME DP - Unbound Medicine ER -