No

Plasma Volume Expander, Colloid

Blood volume expander used in treatment of shock or impending shock when blood or blood products are not available; does not have oxygen-carrying capacity and is not a substitute for blood or plasma

C

Severe bleeding disorders, renal failure with oliguria or anuria, or severe congestive heart failure

Anaphylactoid reactions have occurred; use with caution in patients with thrombocytopenia (may interfere with platelet function); large volume may cause drops in hemoglobin concentrations; use with caution in patients at risk from overexpansion of blood volume, including the very young or aged patients, those with congestive heart failure or pulmonary edema; large volumes may interfere with platelet function and prolong PT and PTT times

<1%: Peripheral edema, heart failure, circulatory overload, fever, chills, headaches, itching, pruritus, vomiting, bleeding, prolongation of PT, PTT, clotting time, and bleeding time, myalgia, hypersensitivity

Symptoms of overdose include heart failure, nausea, vomiting, circulatory overload, bleeding

Treatment is supportive

Do not use if crystalline precipitate forms or is turbid deep brown

Produces plasma volume expansion by virtue of its highly colloidal starch structure, similar to albumin

Onset of volume expansion: I.V.: Within 30 minutes

Duration: 24-36 hours

Metabolism: Molecules >50,000 daltons require enzymatic degradation by the reticuloendothelial system or amylases in the blood prior to urinary and fecal excretion

Elimination: Smaller molecular weight molecules are readily excreted in urine

I.V. infusion (requires an infusion pump):

Adults: 500-1000 mL (up to 1500 mL/day) or 20 mL/kg/day (up to 1500 mL/day); larger volumes (15,000 mL/24 hours) have been used safely in small numbers of patients

Dosing adjustment in renal impairment: Cl_cr <10 mL/minute: Initial dose is the same but subsequent doses should be reduced by 20% to 50% of normal

No information available to require special precautions

No effects or complications reported

Report immediately any respiratory difficulty, acute headache, muscle pain, or abdominal cramping. Pregnancy precautions: Inform prescriber if you are pregnant.

Anaphylactoid reactions can occur, have epinephrine and resuscitative equipment available

Infusion, in sodium chloride 0.9%: 6% (500 mL)

Brutocao D, Bratton SL, Thomas JR, et al, "Comparison of Hetastarch With Albumin for Postoperative Volume Expansion in Children After Cardiopulmonary Bypass," J Cardiothoracic Vasc Anesth, 1996, 10(3):348-51.