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.