Hydroxyethyl Starch 130/0.4
Class: Replacement Preparations
Chemical Name: Starch 2-hydroxyethyl ether
CAS Number: 9005-27-0
Brands: Voluven
Warning
Increased mortality and/or severe renal injury requiring renal replacement therapy reported in critically ill adults, including those with sepsis. Avoid use in such patients. (See Contraindications and also see Increased Mortality and Severe Renal Injury under Cautions.)
Introduction
Third-generation hydroxyethyl starch (HES) (tetrastarch); a nonprotein synthetic colloid used as a plasma volume expander.
Uses for Hydroxyethyl Starch 130/0.4
Hypovolemia
Prevention or treatment of hypovolemia.
Not a substitute for RBCs or coagulation factors in plasma.
Comparable with 6% hetastarch in 0.9% sodium chloride injection as a plasma volume expander in patients undergoing major elective orthopedic surgery.
Provides no mortality benefit over normal saline (0.9% sodium chloride injection) when used in patients admitted to the intensive care unit (ICU) and may be associated with an increased risk of severe renal injury (i.e., requirement for renal replacement therapy). Contraindicated in critically ill adults, including those with sepsis. (See Contraindications and also see Increased Mortality and Severe Renal Injury under Cautions.)
Hydroxyethyl Starch 130/0.4 Dosage and Administration
General
In patients with severe dehydration, administer a crystalloid solution prior to administration of hydroxyethyl starch 130/0.4. Administer sufficient volume of fluid to avoid dehydration.
Administration
IV Administration
For solution and drug compatibility, see Compatibility under Stability.
Administer by IV infusion.
May administer repeatedly over several days; however, change administration sets at least once every 24 hours.
Discontinue infusion if an adverse reaction occurs.
Solution containing hydroxyethyl starch 130/0.4 in 0.9% sodium chloride injection is intended for single use only; discard unused portions.
Rate of Administration
Determine rate of infusion based on amount of blood lost, patient’s hemodynamic status, and resultant hemoconcentration (i.e., dilution effect of drug).
Infuse initial 10–20 mL slowly; closely observe patient for possible anaphylactoid reactions.
Dosage
Determine dosage based on amount of blood lost, patient's hemodynamic status, and resultant hemoconcentration (i.e., dilution effect of drug).
Pediatric Patients
Hypovolemia
IV
Determine dosage based on colloid needs of the patient, taking into account the patient's disease state and hemodynamic and hydration status.
Manufacturer recommends dosage of up to 3 g/kg (50 mL/kg) daily for all pediatric age groups.
In clinical studies, children <2 years of age received a mean dose of 0.96 g/kg (16 mL/kg), and children 2–12 years of age received a mean dose of 2.2 g/kg (36 mL/kg).
Adults
Hypovolemia
IV
Manufacture...
