Dear Donna, Hydroxyethyl starches are now contraindicated in critical illness.
For the European position, see: 1. Assessment report for solutions for infusion containing hydroxyethyl starch. Procedure under Article 31 of Directive 2001/83/EC resulting from pharmacovigilance data. Procedure number: EMEA/H/A-31/1348. EMA Nov 11th 2013. http://www.ema.europa.eu/docs/en_GB/document_library/Referrals_document/Solutions_for_infusion_containing_hydroxyethyl_starch/Recommendation_provided_by_Pharmacovigilance_Risk_Assessment_Committee/WC500154414.pdf 2. Pharmacovigilance Risk Assessment Committee (PRAC) (Page 11). PRAC minutes of the meeting on 7-10 October 2013. European Medicines Agency 2013. http://www.google.co.uk/url?sa=t&rct=j&q=ema%2Fprac%2F708968%2F2013%20corr.&source=web&cd=1&cad=rja&ved=0CC0QFjAA&url=http%3A%2F%2Fwww.ema.europa.eu%2Fdocs%2Fen_GB%2Fdocument_library%2FMinutes%2F2013%2F11%2FWC500154424.pdf&ei=PNDaUpSsKYiJ7AakzYDoDw&usg=AFQjCNHqu9e1NY7PpmECa6QH07jP2xG2AQ 3. Assessment report for solutions for infusion containing hydroxyethyl starch. Procedure under Article 107i of Directive 2001/83/EC. Procedure number: EMEA/H/A-107i/1376. EMA Nov 11th 2013 http://www.ema.europa.eu/docs/en_GB/document_library/Referrals_document/Hydroxyethyl_starch-containing_medicines_107/Recommendation_provided_by_Pharmacovigilance_Risk_Assessment_Committee/WC500154254.pdf 4. European Medicines' Agency. Hydroxyethyl-starch solutions (HES) should no longer be used in patients with sepsis or burn injuries or in critically ill patients - CMDh endorses PRAC recommendations. http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/referrals/Hydroxyethyl_starch-containing_solutions/human_referral_prac_000012.jsp&mid=WC0b01ac05805c516f 5. National Institute for Health and Care Excellence. Clinical Guideline 174. Intravenous fluid therapy in adults in hospital. NICE December 2013. http://guidance.nice.org.uk/CG174/NICEGuidance/pdf 6. Open letter to EMA - Hydroxyethyl Starch. BJA 2013: December 12th. http://bja.oxfordjournals.org/forum/topic/brjana_el%3B11012 7. Bion J, Bellomo R, Myburgh J, Perner A, Reinhart K, Finfer S. Hydroxyethyl starch: putting patient safety first. Intensive Care Med. 2013 Dec 19. http://link.springer.com/article/10.1007%2Fs00134-013-3167-6#page-2 8. Gillies MA, Habicher M, Jhanji S, Sander M, Mythen M, Hamilton M, Pearse RM. Incidence of postoperative death and acute kidney injury associated with i.v. 6% hydroxyethyl starch use: systematic review and meta-analysis. Br J Anaesth 2014; 112(1): 25-34. doi: 10.1093/bja/aet303. In the context of perioperative fluid management, a joint statement will be issued shortly by the Faculty of Intensive Care Medicine, Intensive Care Society, Royal College of Anaesthetists recommending that crystalloids are used, not starches. Regards Professor Julian Bion From: [email protected] [mailto:[email protected]] On Behalf Of Hixson, Donna Sent: 28 January 2014 17:00 To: '[email protected]' Subject: [Sepsis Groups] Albumin & Hetastarches Is there a new conversion list for the hetastarch and albumin fluid amounts? Is it safe to say since the colloids are increased by 1/3 the other fluids should follow? [cid:[email protected]] With Regards, Donna Hixson R.N. Research Outcomes Nurse Vascular Registry [email protected]<mailto:[email protected]> Office (727) 462-7615 Fax (727) 462-3638 MS 73 Confidential: This electronic message and all contents contain information from BayCare Health System which may be privileged, confidential or otherwise protected from disclosure. The information is intended to be for the addressee only. If you are not the addressee, any disclosure, copy, distribution or use of the contents of this message is prohibited. If you have received this electronic message in error, please notify the sender and destroy the original message and all copies.
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