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Hydroxyethyl Starch + Sodium Chloride: Brands, Price & Uses in Bangladesh
Hydroxyethyl Starch + Sodium Chloride is a colloid intravenous fluid indicated for the treatment and prophylaxis of hypovolemia (low circulating blood volume) when treatment with crystalloid…
About Hydroxyethyl Starch + Sodium Chloride
Indications of Hydroxyethyl Starch + Sodium Chloride
Hydroxyethyl Starch + Sodium Chloride is a colloid intravenous fluid indicated for the treatment and prophylaxis of hypovolemia (low circulating blood volume) when treatment with crystalloid solutions alone is considered insufficient.
- Established/approved use: Volume replacement for acute (sudden) blood loss during surgery or trauma, in patients who are not critically ill.
- Adjunct use: Short-term plasma volume expansion as part of a broader fluid resuscitation strategy, alongside crystalloids and, where indicated, blood products.
Hydroxyethyl Starch + Sodium Chloride does not replace red blood cells or plasma coagulation factors and is not intended as a substitute for blood transfusion when blood products are clinically required.
Important restriction: Current safety data show that Hydroxyethyl Starch + Sodium Chloride should generally not be used in critically ill patients (including those with sepsis), in patients with pre-existing renal impairment, or in burn injury patients, because of an increased risk of death and severe kidney injury in these populations. Use in these settings is considered inappropriate and not evidence-supported.
Dosage & Administration of Hydroxyethyl Starch + Sodium Chloride
| Indication | Adult Dose | Pediatric Dose |
|---|---|---|
| Acute hypovolemia (non-critically ill, e.g. surgical/trauma blood loss) | Individualized based on blood loss, hemodynamic status, and hemodilution effect; total daily dose commonly limited to a maximum of approximately 30-33 mL/kg body weight per day depending on the specific product concentration/substitution grade used, per local product labeling. | Individualized and weight-based (commonly cited around 15-25 mL/kg/day in published pediatric experience), used cautiously and only when clearly indicated; exact dosing should follow the specific product's approved labeling. |
Hydroxyethyl Starch + Sodium Chloride is administered by slow intravenous infusion, with the initial 10-20 mL infused slowly while the patient is observed closely for early signs of an anaphylactoid/hypersensitivity reaction. The infusion rate and total volume must be individualized to the patient's hemodynamic response, ongoing fluid losses, and hemodilution, and should be given at the lowest effective dose for the shortest possible duration.
Renal impairment: Hydroxyethyl Starch + Sodium Chloride should not be used in patients with significant renal impairment or those on renal replacement therapy (see Contraindications).
Hepatic impairment: Use with caution and enhanced monitoring in patients with liver disease; avoid in severe hepatic impairment (see Contraindications).
Side Effects of Hydroxyethyl Starch + Sodium Chloride
Adverse effects reported with Hydroxyethyl Starch + Sodium Chloride include:
- Common: Pruritus (itching, which may be delayed and persistent), elevated serum amylase (without necessarily indicating pancreatitis), and hemodilution-related effects (e.g., lowering of hematocrit and plasma proteins).
- Less common but clinically important: Coagulation abnormalities/increased bleeding tendency, renal impairment or acute kidney injury, and fluid overload.
- Rare but serious: Anaphylactoid/hypersensitivity reactions (ranging from mild skin reactions to severe anaphylaxis), and, with repeated or high cumulative dosing, tissue accumulation.
Patients should seek urgent medical attention for signs of severe allergic reaction, unusual bleeding, decreased urine output, or breathing difficulty during or after infusion of Hydroxyethyl Starch + Sodium Chloride.
Contraindications of Hydroxyethyl Starch + Sodium Chloride
Hydroxyethyl Starch + Sodium Chloride is contraindicated in:
- Known hypersensitivity to hydroxyethyl starch or any component of the formulation.
- Critically ill patients, including those with sepsis or in intensive care settings (increased risk of death and renal replacement therapy).
- Patients with renal impairment/renal failure, including those receiving renal replacement therapy (dialysis).
- Patients with severe hepatic disease.
- Patients with severe coagulopathy or pre-existing bleeding disorders.
- Intracranial or cerebral hemorrhage.
- Fluid overload states, including pulmonary edema and severe congestive heart failure.
- Severe hypernatremia or severe hyperchloremia.
- Burn injury patients (per current safety restrictions).
Frequently Asked Questions about Hydroxyethyl Starch + Sodium Chloride
What is Hydroxyethyl Starch + Sodium Chloride used for?
Hydroxyethyl Starch + Sodium Chloride is an intravenous fluid used to treat or prevent hypovolemia (low blood volume), typically for acute blood loss during surgery or trauma, when crystalloid fluids alone are not considered sufficient. It is given only under medical supervision, usually in a hospital.
Can Hydroxyethyl Starch + Sodium Chloride be used in patients with sepsis or in intensive care?
No. Hydroxyethyl Starch + Sodium Chloride is contraindicated in critically ill patients, including those with sepsis, because studies have shown an increased risk of death and severe kidney injury requiring dialysis in this population. It should not be used in intensive care settings for this reason.
What are the main side effects of Hydroxyethyl Starch + Sodium Chloride?
Common effects include itching (which can be delayed and persistent), elevated blood amylase levels, and dilution effects on blood components. Less common but important effects include bleeding tendency, kidney injury, and fluid overload. Severe allergic reactions are rare but require immediate medical attention.
Is Hydroxyethyl Starch + Sodium Chloride safe during pregnancy?
There are no adequate, well-controlled studies of Hydroxyethyl Starch + Sodium Chloride in pregnant women. It should be used in pregnancy only if clearly needed and if the potential benefit to the mother justifies the potential risk to the fetus, and only under a physician's direct supervision.
Who should not receive Hydroxyethyl Starch + Sodium Chloride?
Hydroxyethyl Starch + Sodium Chloride should not be given to patients who are critically ill or septic, have kidney failure or are on dialysis, have severe liver disease, have severe bleeding/clotting disorders, have intracranial bleeding, are in a state of fluid overload, have severe sodium/chloride abnormalities, or are hypersensitive to the product.
What should I do if I notice signs of an overdose or fluid overload with Hydroxyethyl Starch + Sodium Chloride?
If signs such as difficulty breathing, swelling, or reduced urine output occur during or after infusion of Hydroxyethyl Starch + Sodium Chloride, the infusion should be stopped immediately and emergency medical attention should be sought right away; this should always be managed by qualified medical staff.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.