DEXTRAN 40 (dex'tran) Gentran 40, 10% LMD, Rheomacrodex Classifications: plasma volume expander; Therapeutic: plasma volume expander Prototype: Albumin Pregnancy Category: C |
10% solution in D5W or NS
Low-molecular-weight polysaccharide. As a hypertonic colloidal solution, produces immediate and short-lived expansion of plasma volume by increasing colloidal osmotic pressure and drawing fluid from interstitial to intravascular space.
Cardiovascular response to volume expansion includes increased BP, pulse pressure, CVP, cardiac output, venous return to heart, and urinary output.
Adjunctively to expand plasma volume and provide fluid replacement in treatment of shock or impending shock. Also used in prophylaxis and therapy of venous thrombosis and pulmonary embolism. Used as priming fluid or as additive to other primers during extracorporeal circulation.
Hypersensitivity to dextrans, severe renal failure, hypervolemic conditions, severe CHF, significant anemia, hypofibrinogenemia or other marked hemostatic defects including those caused by drugs, (e.g., heparin, warfarin); pregnancy (category C), lactation.
Active hemorrhage; severe dehydration; chronic liver disease; impaired renal function; thrombocytopenia; patients susceptible to pulmonary edema or CHF.
Shock Adult/Adolescent/Child: IV Up to 20 mL/kg in the first 24 h (doses up to 10 mL/kg/d may be given for a maximum of 4 additional days if needed) Prophylaxis for Thromboembolic Complications Adult: IV 5001000 mL (10 mL/kg) on the day of operation followed by 500 mL/d for 23 d, may continue with 500 mL q23d for up to 2 wk if necessary Priming for Extracorporeal Circulation Adult: IV 1020 mL/kg added to perfusion circuit |
Intravenous
PREPARE: IV Infusion: Use only if seal is intact, vacuum is detectable, and solution is absolutely clear. ADMINISTER: IV Infusion: Specific flow rate should be prescribed by physician. For emergency treatment of shock in adults give first 500 mL rapidly (e.g., 2040 mL/min); give remaining portion of the daily dose over 824 h or at the rate prescribed. INCOMPATIBILITIES Solution/additive: Amoxicillin, ampicillin, oxacillin, penicillin. |
When blood samples are drawn for study, notify laboratory that patient has received dextran. Blood glucose: false increases (utilizing ortho-toluidine methods or sulfuric or acetic acid hydrolysis). Urinary protein: false increases (utilizing Lowry method). Bilirubin assays: false increases when alcohol is used. Total protein assays: false increases using biuret reagent. Rh testing, blood typing and cross-matching procedures: dextran may interfere with results (by inducing rouleaux formation) when proteolytic enzyme techniques are used (saline agglutination and indirect antiglobulin methods reportedly not affected).
Assessment & Drug Effects
Patient & Family Education