Dextran (Dextran 40, Dextran 70, Dextran 75)

Category:

  • Plasma Expanders

Description:

  • Dexran 40: Low molecular weight glucose polymer plasma expander

  • Dextan 70 & 75: High molecular weight glucose polymer plasma expander

Indications:

  • Fluid replacement in certain types of shock if whole blood or blood products not available

  • Priming fluid in pump oxygenators

  • Prophylaxis of venous thrombosis and pulmonary embolism associated with high risk thromboembolic surgeries

  • Improve circulation in sickle cell and MI patients

Contraindications:

  • Allergy to dextran

  • Product is not clear

Precautions:

  • Observe initially for hypersensitivity reactions

  • Heart failure

Adverse Reactions (Side Effects):

  • Urticaria, pulmonary edema

  • Anaphylaxis

Dosage:

Administered via intravenous infusion

  • Dextran 40: 

    • IV INF 10% (contains no preservative; discard unused product)

    • Shock: 

      • Max 2 g/kg (20ml/kg) first 24 hours; 

      • Do not exceed 1 g/kg (10ml/kg) per 24 hours thereafter.  

      • Therapy max 5 days.  

      • Infuse first 500ml rapidly, infuse remaining slowly.

    • Prophylaxis of Venous Thrombosis and Pulmonary Embolism: 

      • On day of surgery, IV INF 10% 50-100g (500-1000ml or approximately 10 ml/kg). 

      • Additional 2-3 days dose 50g (500ml) daily. 

      • Depending on risk, 50g every second or third day up to 2 weeks.

  • Dextran 70/75: 

    • IV INF 6% (contains no preservative; discard unused product)

    • Max 1.2 g/kg (20ml/kg) first 24 hours

    • Additional therapy max 0.6 g/kg (10 ml/kg) daily.  

    • Usual adult dose 30g (500ml).  

    • Rate of infusion should not exceed 0.24g (4ml) per minute.

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