Voluven Administration Guidelines

Contraindications and Precautions

The American Society of Anesthesiologists and other guideline societies recommend that Voluven (6% HES 130/0.4) is contraindicated in critically ill patients, including those with sepsis, renal dysfunction, or severe liver disease, and should not be used for volume replacement therapy in surgical patients, due to increased mortality and need for renal replacement therapy 1, 2
The European Medicines Agency recommends that HES no longer be used for volume resuscitation, particularly in sepsis patients, based on high-quality evidence showing no benefit over crystalloids and significant harm 2, 3

The British Journal of Anaesthesia perioperative guidelines provide a strong recommendation against using synthetic colloids (including Voluven) for volume replacement therapy in surgical patients until new evidence emerges, based on high-quality evidence showing no benefit over crystalloids and significant harm 1
The American College of Surgeons recommends using balanced crystalloids (lactated Ringer's or Plasma-Lyte) as first-line therapy for volume resuscitation, administering at least 30 mL/kg within the first 3 hours for sepsis, and aiming for 1-2 L positive balance by the end of surgery to protect renal function 1, 4

Balanced crystalloids reduce the risk of acute kidney injury compared to 0.9% saline, and should be used to protect renal function in surgical patients 1, 5, 3