HES 6% does not affect the definition of the blood group.
It should be borne in mind that too rapid intravenous administration of the drug, as well as its use in high doses, can lead to violations of hemodynamics.
In the process of treatment, it is necessary to monitor the sufficient intake of fluid into the body (at least 2-3 liters of fluid per day), monitor the electrolyte composition of blood serum and fluid balance, as well as kidney function. To prevent the emergence of hyperhydration, which can lead to decompensation of heart failure in patients with heart disease in history, it is necessary to monitor cardiac activity and BCC.
If there is a lack of fibrinogen, the drug can be used only in case of emergency care, when the life of the patient is at risk in the absence of components of the donor blood.
In connection with the risk of developing allergic (anaphylactoid) reactions, careful monitoring of the patient's condition and the establishment of a low rate of drug administration are necessary. Symptoms of anaphylaxis may appear within a few minutes. Symptoms that cause anxiety are severe itching and redness of the skin (a sudden rush of blood to the face, neck). Sometimes the patient suffers suffocation, there is a feeling of "coma in the throat". Characteristic for the next stage are nausea and cramps in the abdomen, as well as tachycardia and arterial hypotension, which can lead to loss of consciousness, up to the stopping of breathing and the cessation of cardiac activity.
In case of intolerance reactions, the drug should be stopped immediately and the necessary emergency measures taken.
The use of HES 6% is contraindicated in patients with renal insufficiency and / or receiving renal replacement therapy.At the beginning of therapy with the drug, control of the level of serum creatinine is necessary.
With the appearance of the first signs of kidney disorders, the introduction of the HES 6% drug should be discontinued. An increase in the need for renal replacement therapy was reported up to 90 days after the introduction of HES. It is recommended that the function of the nights be monitored for at least 90 days after the application of HES preparations.
The literature describes the relationship between the dose and frequency of itching in otoneurological diseases, such as severe hearing loss, tinnitus, and sound trauma. In these diseases, to reduce the incidence of itching, it is recommended to limit the dose of HES 6% to 250 ml per day.
The use of HES 6% in patients with hepatic insufficiency of severe severity is contraindicated.
Care should be taken when using HES 6% in patients with moderate and mild hepatic insufficiency and in patients with coagulation disorders. In the treatment of patients with hypovolemia, severe hemodilution should be avoided.In the case of repeated use of the drug should carefully monitor the parameters of blood coagulability. At the first signs of coagulopathy, the use of HES 6% should be discontinued.
Adequate long-term data on the use of HES 6% in patients who underwent surgery or traumatized are absent. The expected benefit of treatment should be carefully correlated with uncertain long-term safety. Other available therapeutic measures should be considered.
In patients who undergo open heart surgery using the artificial circulation system, the use of HES preparations is not recommended because of the risk of massive bleeding.
To prevent complications of the cardiovascular system and kidneys caused by hypervolemia, elderly patients who are more likely to have cardiac and / or renal failure need careful dose selection and control during treatment.
Due to the availability of limited data on the use of HES in children, its use in this category of patients is not recommended.