A hydroxyethyl starch (HES) solution should be used with caution in certain situations when the risk of an adverse effect is increased.


Absolute contraindications:

(1) history of anaphylactic response to HES

(2) clinical coagulopathy, especially von Willebrand's disease


Relative contraindications (use with caution):

(1) sepsis

(2) acute ischemic stroke

(3) intracranial surgery

(4) intrathoracic surgery (cardiac surgery, cardiopulmonary bypass, etc.)

(5) major trauma, especially after head trauma

(6) major surgery in the neck (carotid endarterectomy, radical neck dissection)

(7) any situation where increased blood loss would be poorly tolerated

(8) pre-existing impaired renal function, especially in a transplanted kidney


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