Hydroxyethyl Starch + Sodium Chloride

Expansol (6% Hydroxyethyl Starch 130/0.4 in 0.9% Sodium Chloride IV infusion) is a clear to slightly opalescent, colorless to slightly yellow, sterile, non-pyrogenic, isotonic solution. It is a colloidal solution that expands plasma volume when administered intravenously. It is used for the treatment and prophylaxis of hypovolemia.

• Hypovolemia (reduced blood volume) - treatment and prophylaxis in adults and children

Adult Dose (IV Infusion):

• Most commonly used: up to 33 ml/kg per day
• Limited experience: 33-50 ml/kg/day
• Initial 10-20 ml should be infused slowly (monitor for anaphylactoid reactions)

Pediatric Dose (IV Infusion):

• Average: 16±9 ml/kg per day
• Dosage should be adapted to individual patient colloid needs, disease state, hemodynamic and hydration status

Most Common Reactions (incidence >1%):

• Pruritus (itching)
• Elevated serum amylase
• Hemodilution

Anaphylactoid/Hypersensitivity Reactions: Influenza-like symptoms, bradycardia, tachycardia, bronchospasm, non-cardiac pulmonary edema

Precautions:

• Monitor for anaphylactoid reactions; discontinue immediately if reaction occurs
• Avoid use in pre-existing renal dysfunction; discontinue at first sign of renal injury
• Monitor coagulation status in open heart surgery patients; discontinue at first sign of coagulopathy
• Avoid fluid overload; adjust dosage in cardiac or renal dysfunction
• In severe dehydration, give crystalloid solution first
• Monitor fluid balance, serum electrolytes, kidney function, acid-base balance, coagulation parameters during prolonged therapy
• Monitor liver function

Contraindications:

• Critically ill adult patients (including sepsis) - increased risk of mortality and renal replacement therapy
• Severe liver disease
• Known hypersensitivity to Hydroxyethyl Starch
• Clinical conditions with volume overload
• Pre-existing coagulation or bleeding disorders
• Renal failure with oliguria or anuria
• Patients receiving dialysis treatment
• Severe hypernatremia or severe hyperchloremia
• Intracranial bleeding

Use in Pregnancy: No adequate and well-controlled studies in pregnant women; use only if potential benefit justifies potential risk to fetus.

Use in Lactation: It is not known whether this drug is excreted in human milk.

Renal Impairment: Avoid use in pre-existing renal dysfunction; discontinue at first sign of renal injury; monitor renal function for at least 90 days.

Hepatic Impairment: Contraindicated in severe liver disease; monitor liver function in patients receiving Hydroxyethyl Starch products.

Overdose: Overloading of the circulatory system (e.g., pulmonary edema) may occur; stop infusion immediately and administer diuretic if necessary.