Disseminated intravascular coagulation due to intravenous administration of hetastarch.

Disseminated intravascular coagulation occurred in a patient after intravenous administration of hetastarch. The onset was acute within 3 hours after exposure to the agent and the course was fulminating. The patient died in 48 hours. Clinical, hematologic, and pathologic features are presented and possible pathophysiologic mechanism is discussed. In view of this experience and documented effects of hetastarch on coagulation, the use of hetastarch should be avoided if the patient has a history of coagulation disorder, and the patient receiving the agent should be closely monitored with appropriate coagulation tests.