Coagulation, oncotic and haemodilutional effects of a third-generation hydroxyethyl starch (130/0.4) solution in horses.

Summary

# Editorial Summary Hydroxyethyl starch solutions have long been used in equine practice for rapid plasma volume expansion and to counteract hypoproteinaemia, yet their tendency to impair blood coagulation has limited clinical confidence in their application. Viljoen and colleagues investigated whether third-generation tetrastarch (130/0.4)—already shown in human medicine to have a more favourable coagulation profile than earlier HES formulations—would demonstrate similarly improved safety in horses. Using in vitro and ex vivo thromboelastographic analysis alongside standard coagulation assays and haematological markers, the team assessed how this solution affected clotting function, plasma oncotic pressure, and haemodilution compared with other fluid options. The findings suggested that 130/0.4 tetrastarch produced measurably less coagulopathy than first- and second-generation starches whilst maintaining effective plasma expansion and oncotic support. These results have clear implications for clinicians managing hypoproteinaemic or hypovolaemic horses, particularly surgical and critically ill cases where both fluid resuscitation and haemostatic competence are essential; however, practitioners should consider whether the improved coagulation profile justifies the cost difference relative to alternative crystalloid or albumin-based protocols.

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Key Findings

• •Third-generation HES (130/0.4 tetrastarch) demonstrates less profound effects on coagulation compared with first- and second-generation HES products
• •HES administration provides rapid plasma volume expansion and oncotic support in horses
• •Coagulopathies remain a significant side effect associated with HES use, limiting clinical application in veterinary medicine

Conditions Studied

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