[Case in which massive hydroxyethylated starch (HES) infusion was useful for massive hemorrhage in spite of progressive hemodilution].

A 72-year-old man with no internal complication underwent total prostatectomy. During operation, massive hemorrhage occurred. Because of delay in transfusion, hemodilution progressed until minimum hemoglobin concentration of 1.6 g x dl(-1): minimum hematocrit of 4.8%. In spite of this extreme hemodilution, we could stabilize his hemodynamics and he recovered without any apparent damage in major organs. For management of hemodynamics a massive dose of hydroxyethylated starch (HES) was infused to maintain the intravascular volume. For massive hemorrhage, HES infusion may be useful to keep hemodynamics in spite of progressive hemodilution.