(1989; 60 pages) [French]
Group: plasma-volume expander
Injectable solution: 60 mg/ml (6%)
Dextrans are long-chain glucose polysaccharides of various relative molecular masses. Dextran 70 (relative molecular mass 70 000) is retained in the intravascular space where, like albumin, it contributes to the colloid oncotic pressure of plasma. Unlike albumin, dextran 70, when given in large amounts, prevents platelet aggregation and facilitates fibrinolysis.
Commercially available solutions of dextran 70 are made up in either glucose 50 mg/ml or saline 9 mg/ml.
• Restoration of circulatory volume during surgery, in hypovolaemic shock due to trauma and dehydration, or following haemorrhage when:
- blood loss is estimated to be less than 15%, or
- full cross-matching of blood for transfusion has not been completed, or
- blood supplies for transfusion have not been adequately screened for viable pathogens.
• Prevention of postoperative deep-vein thrombosis.
Dosage and administration
Acute blood loss
Adults: 500-1000 ml of dextran 70 may be infused intravenously over 15 minutes to compensate for moderate blood loss.
Prevention of thromboembolic phenomena.
Adults: 500 ml preoperatively, repeated daily for 2-3 days postoperatively.
• Known hypersensitivity to dextran 70.
• Thrombocytopenia (since dextran 70 interferes with platelet function).
Patients should be closely observed during the first minutes of administration as severe hypersensitivity reactions may occur. Equipment for resuscitation should be immediately available.
Blood samples for cross-matching should routinely be taken before administration of dextran 70 since it promotes rouleaux formation and thereby interferes with the cross-matching process.
The infusion must be stopped immediately if signs of pulmonary oedema develop.
When given in large amounts (> 15 ml/kg) dextran 70 may interfere with platelet function and produce a transient increase in bleeding time.
Urticaria, nasal congestion, wheezing, tightness of the chest and mild hypotension are reported and severe anaphylactoid reactions with circulatory collapse have also occasionally occurred.
Dextran 70 solution should be stored at a constant temperature, preferably 25°C. It should not be administered unless clear. Precipitates formed during storage may be dissolved by heating in a water bath at 100°C.