Pros and cons of tetrastarch solution for critically ill patients

Table 2 Characteristics of colloid solutions

Product	Concentration (%)	Oncotic pressure (mmHg)	Initial volume expansion^a(%)	Persistence in the body (days)	Maximal dose/24 h	Carrier solution	Effect on hemostasis	Comments
Albumin	4	20–29	80	n/a		Na 148 mEq/l	0
	20	100–120	200 ~ 400			Cl 128 mEq/l
						Na n/a
						Cl 19 mEq/l
Dextran 70	6	56–68	120	28 ~ 42	1.5 g/kg		+++
Dextran 40	10	168–191	200	6	1.5 g/kg		+++
Fluid gelatin	4	42	70	2 ~ 7		Na 154 mEq/l	0 ~ +
			90	7		Na 154 mEq/l
			90	7		Cl 120 mEq/l
Urea-linked gelatin	3.5	25–29	70 ~ 80	2 ~ 7		Na 145 mEq/l	0 ~ +
Urea-linked gelatin	3.5	25–29	70 ~ 80	2 ~ 7		Cl 145 mEq/l	0 ~ +
HES 670/0.75	6	25–30	100		20 ml/kg	Lactate Ringer	++(+)
HES 200/0.5	6	30–37	100	3 ~ 4	33 ml/kg		+
HES 70/0.5	6		80 ~ 90		20 ml/kg	Either saline or balanced solution	0 ~ +
HES 200/0.5	10	59–82	145	3 ~ 4	20 ml/kg		+	Used in VICEP study [12]
HES 130/0.4	6	36	100	<1	50 ml/kg	Either saline or similar to acetate Ringer but no Ca	0 ~ +	Used in CHEST study [13] and CRYSTMAS study [14]
HES 130/0.42	6				33 ml/kg	Acetate Ringer		Used in 6S trial [15]

Modified from references [9–11]. HES products are summarized as in vitro molecular weight/degree of substitution. ^aExpressed as plasma volume increase/administered volume (%). The number of plus sign suggests the semi-qualitative comparison between each item.

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