Wednesday July 8, 2009

Q: Which very commonly use resuscitation fluid in ICU may cause pesudo-hyperamylasemia?


Answer: Hetastarch

The infusion of hydroxyethyl-starch leads to hyperamylasemia due to the complex structural interrelation of the amylase molecules in the serum and the hydroxyethyl-starch molecules. The amylase clearance is reduced because glomerular filtration of the macromolecules thus formed is not possible. It takes about a week for a level to return to normal after hetastarch infusion.

Workup for presumed pancreatitis may be expensive and futile.



References: Click to get abstract

1. Gofferje H, Kozlik V. [Hyperamylasemia following infusion of hydroxyethyl starch with different molecular weight distributions - Infusionsther Klin Ernahr. 1977 Jun;4(3):141-4

2. Treib J, Baron JF, Grauer-MT, Strauss-RG. An international view of hydroxyethyl starches. Intensive Care Med 1999;25:258–68.