The Pennine Acute Hospitals
NHS Trust Formulary
 
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9 Nutrition and blood
09-02-02-02 Plasma substitutes

Gelatin Gelaspan®
First Choice

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Gelatin Gelofusine®
Second Choice
May be supplied as an alternative to Gelaspan if unavailable

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Dextran 40®
Non Formulary

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Dextran 70®
Non Formulary

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Etherified Starch HAES-steril®
Non Formulary

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Etherified Starch Hemohes®
Non Formulary

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Etherified Starch Infukoll®
Non Formulary

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Gelatin Geloplasma®
Non Formulary

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Gelatin Haemaccel®
Non Formulary

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Gelatin Volplex®
Non Formulary

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Hydroxyethyl Starch Products
Non Formulary
e.g. Tetraspan®, Voluven®

Because of the risk of kidney injury and mortality, HES solutions must no longer be used in patients with sepsis, burn injuries or critically ill patients.

HES solutions should only be used for the treatment of hypovolaemia due to acute blood loss when crystalloids alone are not considered sufficient.

There is a lack of robust long-term safety data in patients undergoing surgical procedures and in patients with trauma. The expected benefit of treatment should be carefully weighed against the uncertainties with regard to long-term safety, and other available treatment options should be considered.

HES solutions should be used at the lowest effective dose for the shortest period of time. Treatment should be guided by continuous haemodynamic monitoring so that the infusion is stopped as soon as appropriate haemodynamic goals have been achieved.

HES solutions are now contraindicated in patients with renal impairment or renal replacement therapy. The use of HES must be discontinued at the first sign of renal injury. An increased need for renal replacement therapy has been reported up to 90 days after HES administration. Patients’ kidney function should be monitored after HES administration.

HES solutions are contraindicated in severe coagulopathy. HES solutions should be discontinued at the first sign of coagulopathy. Blood coagulation parameters should be monitored carefully in case of repeated administration.


See EMA Review (via link)
Link  EMA: Hydroxyethyl starch solutions for infusion
 

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Hypertonic Solution HyperHAES®
Non Formulary

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Plasma-lyte 148
Non Formulary

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