In connection with the possibility of developing allergic reactions, the introduction of the first 10-20 ml of the solution should be carried out slowly (drip), monitoring the patient's condition.
Treatment should be carried out under the control of bcc, the concentration of electrolytes, leukocytes, platelets, hemoglobin, blood coagulation, kidney function (especially in children 2-3 years due to the water electrolyte status).
At the beginning of therapy, it is required to monitor the serum creatinine concentration. At the limit values of creatinine concentration (1.2-2 mg / dL or 106-177 μmol / l - compensated renal failure), it is necessary to correlate the possibility and necessity of the therapy and necessarily carry out a constant monitoring of the water-electrolyte balance.
It should be borne in mind that HES can affect clinical and chemical indices (glucose, protein, erythrocyte sedimentation rate (ESR), fatty acids, cholesterol, sorbitol dehydrogenase, specific gravity of urine).
The introduction of high doses of the drug leads to a decrease in hematocrit, hemoglobin concentration and plasma protein.The hemoglobin values below 10% and the hematocrit below 27% are considered critical. Starting with a total protein of less than 5 g / dL, the administration of albumin is indicated. When blood loss is more than 20-25% of bcc, an additional introduction of erythrocyte mass is shown.
In the case of shock conditions caused mainly by the loss of water and electrolytes (pronounced vomiting, diarrhea, burns), after initial treatment with the drug, further treatment should be carried out using a balanced solution of electrolytes. During treatment, it is necessary to ensure a sufficient supply of fluid in the body.
When anaphylactoid reactions occur, the drug should be discontinued, the patient should be placed in the "lying" position with the head down, the airway should be released, then the IV is injected
epinephrine, first diluting 1 ml of the solution (1: 1 thousand) to 10 ml - first slowly injected 1 ml of the resulting solution (0.1 mg), while controlling the pulse and blood pressure, the introduction of epinephrine can be repeated. Then I / in appoint a 5% solution, human albumin (for replenishment of bcc), glucocorticosteroid drugs (250-1000 mg prednisolone), antihistamines.
Patients should be under continuous medical supervision, additional therapeutic measures should be taken depending on the condition of the patients.
In the treatment of patients whose blood group is not established, it must be borne in mind that the introduction of large volumes of HES can make it difficult to interpret the results of the agglutination reaction.
After iv introduction of the drug increases the activity of amylase in the blood, which returns to normal after 3-5 days (may interfere with the laboratory diagnosis of pancreatitis, without affecting the clinical picture).
Care should be taken when driving a car and engaging in other potentially hazardous activities requiring increased attention and speed of psychomotor reactions.