Last reviewed 2026-04-22 · How we verify

tetrastarch (Voluven)

Tetrastarch is a synthetic colloid that expands intravascular volume by osmotically retaining fluid in the bloodstream.

Tetrastarch is a synthetic colloid that expands intravascular volume by osmotically retaining fluid in the bloodstream. Used for Acute blood loss and hypovolemia requiring volume replacement in surgical and trauma patients.

At a glance

Mechanism of action

Tetrastarch (hydroxyethyl starch, HES) is a branched polysaccharide derived from amylopectin that functions as a plasma volume expander. It remains in the intravascular space longer than crystalloid solutions, providing sustained hemodynamic support. The molecule's structure allows it to exert oncotic pressure, drawing and retaining fluid within blood vessels to maintain circulating volume.

Approved indications

• Acute blood loss and hypovolemia requiring volume replacement in surgical and trauma patients

Common side effects

• Acute kidney injury
• Coagulopathy / increased bleeding
• Hyperchloremic acidosis
• Anaphylaxis

Key clinical trials

• Behaviour of Intravenous Solutions in Obese Patients Under General Anesthesia (NA)
• Colloids in Severe Trauma (PHASE4)

Primary sources

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Competitive intelligence

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