Voluven - plasma-substituting drug.
Release form and composition
The drug is produced in the form of a 6% solution for infusions, in 1 liter of which contains:
- 60 g of poly (O-2-hydroxyethyl) starch;
- 9 g of sodium chloride;
- The following electrolytes: Na + 154 mmol / l and Cl - 154 mmol / l;
- Additional components: sodium hydroxide and hydrochloric acid for pH correction, injectable water.
The theoretical osmolarity of the Volyven solution is 308 mOsm / l, the acidity is less than 1 mmol of NaOH / l, pH - 4.0-5.5.
The drug is produced in 250 and 500 ml in polyolefin containers "friflex", as well as 500 ml in plastic bottles with a loop-holder for a dropper.
Indications for use
According to the instructions given to Voluven, this plasma-substituting agent is intended for the treatment and prevention of shock and hypovolemia of any genesis, including in the postoperative period, due to acute adrenal insufficiency, trauma, blood loss, sepsis, burns, anaphylaxis, multiple organ failure, and other conditions that are accompanied by collapse.
In addition, Voluven is used in therapeutic and acute normovolemic hemodilution, as well as to fill the extracorporeal circulation.
The use of Voluven, according to the instructions, is contraindicated in:
- Congestive heart failure;
- Severe blood coagulation disorders;
- Intracranial bleeding;
- Severe renal failure, accompanied by oliguria or anuria;
- The state of dehydration, when the patient needs correction of water and electrolyte balance;
- Hypersensitivity to the drug.
In addition, Voluven is not prescribed to people on hemodialysis.
Dosing and Administration
Voluven is intended for prolonged intravenous administration.
The first 10-20 ml of solution is injected slowly and under particularly careful medical supervision, since there is a high risk of anaphylactoid reactions.
A specific daily dose and exact infusion rate are prescribed by the attending physician in each case individually, taking into account the indications (to maintain hemodynamics or to restore it), the degree of blood loss and hemodilution.
The maximum daily dosage is determined depending on the weight of the patient:
- For adults - 50 ml per kilogram of patient weight;
- For children from 10 to 18 years old - 33 ml per kg;
- For children under 10 years old - 25 ml / kg.
When fast compensation of a hypovolemia, and also if necessary fast filling of the volume of the circulating blood is required, use 500 ml plastic containers with solution which is entered under pressure.
The drug can be administered repeatedly over a long period, depending on the clinical situation. The total duration of use of Voluven depends on the severity of hypovolemia and its duration, as well as on hemodilution and hemodynamic efficacy of the drug.
During the period of treatment with this drug may increase the concentration of serum amylase.
With long-term use of Voluven in high doses, there is a possibility of a decrease in hematocrit, plasma proteins and coagulation factors, as well as the risk of dilution of blood components. In this regard, during the introduction of the solution can be reduced activity of coagulation factor VIII.
Also, with prolonged use of the drug can increase bleeding time and other indicators of blood clotting, but they usually recover to baseline after 6 hours after the infusion of Voluven.
In the presence of intolerance to the drug may develop allergic reactions.
Symptoms of Voluven overdose are manifested by an overload of the circulatory system, such as pulmonary edema. In this case, you should immediately stop the introduction of the solution, if necessary, appoint a diuretic agent.
Clinical data on the use of Voluven during pregnancy and lactation are not available, however, in the course of experimental studies on animals, no adverse effect of the drug on the child’s development, pregnancy, childbirth or postnatal development was found. No signs of teratogenicity were noted. However, during pregnancy, the drug is prescribed only for health reasons.
When using Voluven, as well as other plasma-substituting solutions, it is necessary to avoid overloading the body with fluid. Particularly high risk of overhydration in patients with severe impaired renal function and heart failure.
Structural analogues of Voluven: Venofundin, Volekam, Volekam GEK-200, Volemkor, Hemohys, HydroxyEtilStarch 200, GETA-SORB, Hydroxyethyl starch-Eskom, Infukol GEC, HyperHaes, Plazmalin, Plasmastabil 200, PolyHeCH and 10%, Stabizol HES 6%, HAES-steril, Tetraspan ,.
Analogues of Voluven as belonging to the same pharmacological subgroup (“Plasma preparations and plasma-substituting drugs”) and the mechanism of action are the following drugs: Albumin, Albiomin 20%, Vullayt, Albumin Human Biotest, Alburex, Geloplasma Balance, Gelofuzin, Hemodez-8000, Hemez -N, Hemopyur, Hemostabil, Gluconeodez, Dextran, Gelatinol, Zenalb, Krashemodez 8000, Neo-Hemodez, Neorondex, Perftoran, Anti-Pneumatic Anti-Toxic Human Plasma, Plasbumin 20, Human Anti-Synecous Plasma, Polygluc in, Plasma free citrate, Polyglusol, Polyoxidine, Polyoxyfumarin, Polypher, Reoglyuman, Reopoliglyukin, Rondex, Uman albumin.
Terms and conditions of storage
In pharmacies, Voluven is not sold, but is sold only to medical institutions. It should be stored in a place protected from the sun at a temperature of up to 25 ºС. It is forbidden to freeze! The shelf life of the solution in vials is 5 years, in containers "frelex" - 3 years.