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indications:
Treatment of some types of shock (hypovolemic, post-burn, hemorrhagic, traumatic), prevention of clots and pulmonary embolism in operated patients with a high risk of thromboembolic complications.
Composition:
100 ml of the solution contains 6.0 g of dextran with a molecular weight of approximately 70,000 and 0.9 g of sodium chloride.
Action:
A high molecular weight Glucose polymer with an average molecular weight of 70,000 used in solutions as a means of increasing the volume of circulating blood. Administered intravenously, the colloidoosmotic blood pressure increases, binding water and increasing the volume of plasma (1 g dextran binds 20 ml of water). It causes the displacement of water from the extravascular space into the vascular space. It clearly reduces blood viscosity and has an anticoagulant effect. In the shock phase, it influences the improvement of the capillary blood flow. T0,5 is 6-8 h. Excreted in urine at 65%, the rest is metabolised to carbon dioxide and water. It does not penetrate the blood-brain barrier.
Contraindications:
Hypersensitivity to dextran, developed or threatened pulmonary edema, severe circulatory failure, haemorrhagic diathesis, thrombocytopenia, hypofibrinogenemia, hemorrhagic stroke, severe hypertension, renal failure with oliguria or anuria (serum creatinine concentration above 177 μmol / l). Patients with indications of reduced sodium supply.
Precautions:
Use with caution in patients with congestive heart failure, renal insufficiency (dextran administered in a sodium chloride solution).
Pregnancy and lactation:
Pregnancy only if the expected therapeutic benefits outweigh the risks of use. Use with caution when breastfeeding.
Side effects:
Anaphylactic shock, symptoms of cardiovascular overload with too fast administration, allergic skin reactions, nausea, vomiting, bronchospasm, in patients with impaired renal function - anuria. In laboratory tests: hematocrit lowering, serum protein lowering. After administration of a volume greater than 1000 ml, transient prolongation of the bleeding time may occur.
Dosage:
By intravenous infusion: individually, according to the patient's condition (blood pressure, heart rate, hematocrit values), fluid requirements, age, body weight. In order to increase the volume of plasma and, in the alternative, shock. Adults: usually 1 day 500-1000 ml, maximum not more than 20 ml / kg. during the first 24 hours. In life-threatening situations, the first 500 ml can be administered at a rate of 20-40 ml / min. If the treatment lasts longer than 24 hours, do not exceed the dose of 10 ml / kg. (usually 500 ml). Children: depending on the weight or body surface, the maximum dose is 20 ml / kg / day. In peri-operative antithrombotic prophylaxis: the infusion should be started during the procedure. First dose 500-1000 ml (10 ml / kg) and then administer 500 ml for 2-3 days. Patients with a high risk of embolism may continue treatment every 2-3 days, up to a maximum of 14 days in a daily dose of 500 ml.
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