Hydroxyethyl starch 200/0.5 sodium chloride injection

The raw material of this product is mainly high molecular weight branched starch. One of its characteristics is its unique molecular weight, gram molecular substitution level and substitution mode. The average molecular weight is about 200,000 Daltons. The gram molecular substitution level is about 0.5, that is, there are about 5 hydroxyethyl groups in every 10 glucose units in the branched starch structure, and they are mainly at the C2 position. The C2/C6 ratio is 5:1. The main chain of hydroxyethyl starch is connected by glucose units through alpha;-1,4 chains, and branches are sent out through alpha;-1,6 bond chains. Because it is very similar to glycogen in structure, it can be expected that Hers has high body tolerance and only a very low possibility of allergic reactions. Hers solution has good stability and temperature fluctuations will not cause flocculation. Rapid infusion of Hers can increase plasma volume. When Hers 6% solution is infused, the increased plasma volume is equivalent to 100% of the infusion volume, and when Hers 10% solution is infused, the increased plasma volume is equivalent to 145% of the infusion volume. After that, it remains above 100% within 4 hours; after 8 hours, it still maintains 72% (Hers 6%) or 57% (Hers 10%) of the infused amount. Moreover, Hers 6% has a plateau period of 4 hours, and Hers 10% has a plateau period of 1 hour. Therefore, Hers can effectively improve circulation and microcirculation at least within 4-8 hours. Hers can be continuously degraded by serum amylase in the body and is mainly excreted from the kidneys. Within 24 hours, about 47% of Hers 6% solution or 54% of Hers 10% solution appears in the urine, and at this time only 6% and 10% can be detected in the plasma, respectively.

Hydroxyethyl starch

Volume replacement therapy for the treatment and prevention of insufficient circulating blood volume or shock associated with the following conditions: 1. Surgery, hemorrhagic shock. 2. Trauma, traumatic shock. 3. Infection, septic shock. 4. Burns, burn shock. 5. Reduction of blood supply requirements during surgery: for example, acute isovolumetric hemodilution ANH. 6. Therapeutic hemodilution.

Treatment and prevention of hypovolemia (hypovolemia) and shock (volume replacement therapy): Maximum dose is 33 mL/kg body weight/day (Haes 6%) or 20 mL/kg body weight/day (Haes 10%), and the maximum infusion rate is 20 mL/kg body weight/hour. The duration and dose of treatment depend on the duration and degree of hypovolemia. Reduction of blood volume used in surgery (acute isovolumetric hemodilution - ANH): ANH should be given immediately before surgery to replace autologous blood. After ANH treatment, the target hematocrit should not be less than 30%. The replacement ratio is 1:1 (Haes 6%: blood). The daily dose of Haes 6% is: 2-3x500 mL; phlebotomy: 2-3x500 mL. The infusion and phlebotomy rates are: 1000 mL/15-30 minutes. If it is expected that blood products may be needed to replace blood loss, ANH is usually given once before surgery and can be repeated if the initial hematocrit is normal. Therapeutic hemodilution: The aim is to reduce the hematocrit and treatment is performed by isovolumetric dilution (phlebotomy) or hypervolumetric dilution (without phlebotomy) with low (250 mL), medium (500 mL) or high (2 x 500 mL) doses. Infusion rate: 250 mL in 0.5-2 hours, or 500 mL in 4-6 hours, or 2 x 500 mL in 8-24 hours. Treatment for 10 days is recommended. The first 10-20 mL should be slowly infused intravenously and the patient should be closely monitored (because of the possibility of anaphylactic reactions). Due to the dilution effect on the blood, the daily dose and infusion rate should be determined according to the blood volume and the degree of hemoconcentration. In patients without cardiovascular or pulmonary risk, the hematocrit should not be less than 30% when using colloid volume expanders. Circulatory overload due to too rapid infusion and excessive dosage must be avoided.

In very rare cases, allergic reactions may occur. If intolerance occurs, the infusion should be stopped immediately and routine emergency measures should be taken. Long-term daily administration of moderate and high doses of this drug often leads to a refractory pruritus, which will still occur several weeks after the end of treatment and will cause emotional tension in patients if it lasts for several months. Only very rare cases have been reported of renal pain. In such cases, the infusion should be stopped immediately, and adequate fluids should be provided and serum creatinine values should be closely monitored. When a higher dose is used, bleeding time may be prolonged due to hemodilution, but it will not cause clinical bleeding. The decrease in hematocrit and the dilution of plasma proteins should be monitored.

Severe congestive heart failure (heart failure); renal failure (serum creatinine >2mg/dL and >177umol/L); severe coagulation disorder (but it can still be considered for life-threatening emergencies); excessive fluid load (too much water) and severe fluid deficiency (dehydration); cerebral hemorrhage; starch allergy.

So far, no interactions with other drugs have been found.

Keep sealed.

250 ml: Hydroxyethyl starch 200/0.515 g and sodium chloride 2.25 g