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), carefully monitoring the patient's condition.
Treatment should be carried out under the control of bcc, the content of electrolytes, leukocytes, platelets, hemoglobin, blood coagulation indicators, kidney function.
At the beginning of therapy, it is required to monitor the serum levels of creatinine. If creatinine levels are too low (1.2-2 mg / dL or 106-177 μmol / L - compensated renal failure), it is necessary to carefully weigh the possibility and necessity of the therapy and necessarily to monitor the fluid balance frequently.
It should be borne in mind that the HES can affect clinical and chemical indices (glucose, protein, erythrocyte sedimentation rate, 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. Values of hemoglobin below 10 g% and 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 loss of water and electrolytes (severe vomiting, diarrhea, burns), after initial treatment with the drug, further treatment should be carried out using a balanced solution of electrolytes.
Do not mix the drug with other drugs in the same container and in the same system.
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 transferred to the "lying" position with the lower limbs raised above the head level, and the airways released; then enter intravenously
epinephrine, previously diluted 1 ml of the solution (1: 1 thousand) to 10 ml - first, slowly introduce 1 ml of the resulting solution (0.1 mg), while monitoring the pulse and blood pressure; the introduction of epinephrine can be repeated. Then 5% solution of human albumin (for replenishment of BCC), glucocorticosteroid preparations (250-1000 mg of prednisolone), antihistamine drugs are intravenously administered.
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 in determining the blood group.
After the administration of the drug, the activity of amylase in the blood increases markedly, which returns to the norm in 3-5 days (may interfere with the laboratory diagnosis of pancreatitis without affecting the clinical picture).