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Revisiting the use of hydroxyethyl starch solutions in equine fluid therapy

Summary The last decade has led to major shifts in opinions on the use of hydroxyethyl starch (HES) solutions in fluid therapy, specifically in human patients with sepsis The majority of evidence documenting adverse effects of HES solutions on coagulation and renal health come from studies in people However, these findings have led to investigation into the safety of HES solutions in veterinary species While there are now studies investigating the effects of HES solutions on coagulation and renal health in dogs, cats and horses, information regarding long-term follow-up, clinical significance of these changes and use of these solutions in critically ill animals is still lacking The information presented here serves to review the physiology of oncotic pressure and the rationale behind colloid use, specifically HES solutions Additionally, the foundation of arguments against the use of HES and the available literature regarding HES use in animals will be summarised