Abstract
The profile of an ideal volume substitution solution can be defined by volume effect and safety. The volume effect should be stable and reliable, offer a constant plateau effect and be easily controllable. Many in depth characteristics has been offered by recognized societies [1] and includes: no tissue storage, no plasma accumulation, no influence on haemostasis, no influence on the immune system, no infectivity, no antigenicity, no allergenic potential, no proinflammatory properties, no toxicity, teratogenity or mutagenity, no influence on diagnostic tests, good compatibility with other medication, good tolerance, and complete elimination. Research has shown that it is possible to meet these objectives in the development of hydroxyethyl starches (HES) by optimizing the combination of concentration, the molecular weight, the degree and pattern of substitution. A new starch (HES 130/0.4) has therefore been developed. This new generation of HES offers the same volume effect and duration as the previous standard HES 200/0.5, yet with more favorable pharmacological characteristics and an improved safety profile. The following article is a collection of experts' opinion from different recognized universities, hospitals and healthcare organizations about the evidence based clinical decisions when using Waxy-Maize HES 130/0.4 (Voluven (R)) in various clinical situations. Open access under CC BY-NC-ND license. (C) 2011 Egyptian Society of Anesthesiologists. Production and hosting by Elsevier B. V.