(10 years after the study!); this analysis concluded that the application of hyperoncotic HES within the first 24 hours after severe burns 'may be associated with fatal outcome and should therefore be used with caution'.
Early fluid resuscitation with hyperoncotic hydroxyethyl starch 200/05 (10%) in severe burn injury.
Hypertonic solution administration: Volume expanders such as Mannitol, Dextran and concentrated albumin may assist in raising blood pressure in episodes of IDH; however, these expensive, hyperoncotic
fluids are not without problem (van der Sande et al., 2000).
Hydroxyethyl starch being hyperoncotic
, has the ability to withdraw fluid from interstitial into intravascular space.
A 5% concentration of albumin is a colloid fluid and is hyperoncotic
; thus, the administration of albumin as a replacement fluid can help maintain oncotic pressure to reduce the risk of hypotension.
The oldest study,  from 2008, used a hyperoncotic
(10%) solution of HES 200/0.5 that is no longer used in South Africa and differs significantly from the HES IVFs currently in use.