Starches for fluid therapy: Is it time for a re-appraisal, or has the horse left the barn?

摘要

In 1994, the Canadian Blood Services (CBS) introduced the synthetic colloid, Pentaspan? (10% pentastarch in 0.9% sodium chloride injection, 200/0.45),A a hydroxy-ethyl starch (HES) solution, as an alternative to the human-derived colloid, albumin, for distribution in Canada. Despite attempts to introduce other HES solutions (e.g., Hespan? and Hextend?), Pentaspan remained the only HES solution that CBS supplied at no charge to Canadian hospitals. Circumstances changed in late 2007 when Vol-uven? (6% tetrastarch in 0.9% sodium chloride injection, 130/0.40) was purchased by the CBS for distribution in Canada.