HES 140 Learning Slides
Transcript of HES 140 Learning Slides
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Features: Made from Wax Corn Starch MW 130 KD / DS 0.4 exhibits 100% volume effect Volume duration of 4-6 hours
Indications: Therapy and prophylaxis of
hypovolemia and shockassociated with surgery, trauma,sepsis and burns
Dosage: Up to 50 ml/kg/BW/day
Availability: 500 ml Freeflex Bags in isotonic
saline solution
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Features: Made from Wax Corn Starch MW 130 KD / DS 0.4 exhibits 100% volume effect Volume duration of 4-6 hours
Indications: Therapy and prophylaxis of
hypovolemia and shockassociated with surgery, trauma,sepsis and burns
Dosage: Up to 50 ml/kg/BW/day
Availability: 500 ml Freeflex Bags in an
isotonic electrolyte solution
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6% HES1 3 0 / 0 . 4 / 9 : 1
Molecular Weight Degree of Substitution Substitution Pattern
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6% Voluven / Volulyte1 3 0 / 0 . 4 / 9 : 1
Molecular Weight Degree of Substitution Substitution Pattern
Reduced proportion oflarge, highly substitutedmolecules that may
cause coagulationdisorders.
Results in the maintenanceof adequate volume effect &improvement of safety profile
Known as C2:C6 ratioProvides good duration ofvolume effect
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Waxy Maize Potato Starch
V RSUS
95% amylopectin, 5% amylose
rapidly broken down in the body and
so could have a longer-lasting volumeeffect vs. potato-based starch (e.g.Tetraspan)
Low phosphate-ester groups doesntinterfere with blood clottingmechanism, kidney and liver function
70 -80% amylopectin
20-30% amylose
High load of phosphate-ester groups may interfere with blood clottingmechanism, kidney and liver function
S t r u c t u r a l D i f f e r e n c e s a n dP o s s i b l e o n s e q u e n c e s
http://www.google.com.ph/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=80gnaPfTOXcbhM&tbnid=jO88HhOWHo686M:&ved=0CAUQjRw&url=http://www.gheg.de/de/products/product/4540_Tetraspan_6_10-Hydroxyethyl_starch_130_0.42/index.html&ei=uU57Uvt9qLWJB9SkgbgC&psig=AFQjCNEYF0tEf-GtGs2SXC_t53m-tG9TPg&ust=1383899106331557 -
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PLASMA VOLUME EXPANSION EFFEC
0
20
40
60
80
100
120
140
160
0.5 1 2 3 4 5 6 7 8 Hours after Infusion
Blood Volume
(% Infusion)
Voluven 6% 130/0.4 Crystalloids Gelatins
Voluven / Volulyte 6% 130 / 0.4provides 100% volume effect for upto 4-6 hours
Crystalloids 40%, up to 45 minutes.
Gelatins 70%, up to 2 hours.
AND VOLUME SUBSTITUTION RATIO
3 bags; 1 bag
1;1
4.7 bags ; 1 bag
P L A S MA V O L U ME E X PA N S IO N E F F E C T SA N D V O L U M E S U B S T I T U T I O N R AT I O
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LESS RISK OFANAPHYLACTOID
REACTIONScompared with gelatin anddextransimilar to body glycogen
NO RELEVANT PLASMA
ACCUMULATION
can be safely given to patientsrepeatedly for several dayswithout relevant plasmaaccumulation
NO CLINICALLY RELEVANTINFLUENCE ON RENALFUNCTION
Voluven is safe in patientswith all range of renalimpairment as long as urineflow is preserved
Vo l u v e n &
Vo l u l y t e
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In summary, with Voluven and Volulyte we achieve a balance between:
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Voluven & Volulyte
dont accept imitations