Dextran

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.

Source: Operational Medicine 2001, Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300