Neural Regeneration Research ›› 2021, Vol. 16 ›› Issue (7): 1372-1376.doi: 10.4103/1673-5374.300978

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Hydroxyethylstarch revisited for acute brain injury treatment

Martin A. Schick1, 2, #, Malgorzata Burek3, #, Carola Y. Förster3, #, Michiaki Nagai4, Christian Wunder5, *, Winfried Neuhaus6, *   

  1. 1 Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, Freiburg, Germany;  2 Faculty of Medicine, University of Freiburg, Freiburg, Germany;  3 Department of Anaesthesia and Critical Care, University Hospital Würzburg, Würzburg, Germany;  4 Department of Internal Medicine, General Medicine and Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan;  5 Robert-Bosch-Krankenhaus, Department of Anesthesiology and Intensive Care Medicine, Stuttgart, Germany;  6 Competence Unit Molecular Diagnostics, Center Health and Bioresources, Austrian Institute of Technology GmbH, Vienna, Austria
  • Online:2021-07-15 Published:2021-01-07
  • Contact: Winfried Neuhaus, winfried.neuhaus@ait.ac.at; Christian Wunder, Christian.Wunder@rbk.de.
  • Supported by:
    This work was supported by a grant from the Forschungskommission der Medizinischen Fakultät, Albert-Ludwigs-Universität Freiburg (SCHI1123/17, to MAS).

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Abstract: Infusion of the colloid hydroxyethylstarch has been used for volume substitution to maintain hemodynamics and microcirculation after e.g., severe blood loss. In the last decade it was revealed that hydroxyethylstarch can aggravate acute kidney injury, especially in septic patients. Because of the serious risk for critically ill patients, the administration of hydroxyethylstarch was restricted for clinical use. Animal studies and recently published in vitro experiments showed that hydroxyethylstarch might exert protective effects on the blood-brain barrier. Since the prevention of blood-brain barrier disruption was shown to go along with the reduction of brain damage after several kinds of insults, we revisit the topic hydroxyethylstarch and discuss a possible niche for the application of hydroxyethylstarch in acute brain injury treatment. 

Key words: acute subarachnoid hemorrhage, astrocyte, chronic kidney disease, delayed cerebral ischemia, microglia, neurovascular unit, osmotic pressure, pericyte, stroke, traumatic brain injury