| DEXTRAN 70
Classifications: plasma volume expander; Therapeutic:plasma volume expander
Pregnancy Category: C
6% solution in D5W or NS
High-molecular-weight polysaccharide. The colloidal osmotic effect of dextran draws fluid into the vascular system from
the interstitial spaces, resulting in increased circulating blood volume and decreasing blood viscosity.
Cardiovascular response to volume expansion includes increased BP, pulse pressure, CVP, cardiac output, venous return to
heart, and urinary output.
Primarily for emergency treatment of hypovolemic shock or impending shock caused by hemorrhage, burns, surgery, or other
trauma. Intended for emergency treatment only when whole blood or blood products are not available or when haste precludes
cross-matching of blood.
Nephrosis, toxemia of pregnancy, and prophylaxis of deep vein thrombosis.
Known hypersensitivity to dextrans; severe bleeding disorders; severe CHF; coagulopathy; severe renal failure; pregnancy
(category C), lactation.
Impaired renal function, pulmonary edema, CHF, pathologic GI disorders; thrombocytopenia.
Route & Dosage
Adult: IV 500 mL administered rapidly (over 1530 min), additional doses may be given more slowly up to 20 mL/kg in the first
24 h (doses up to 10 mL/kg/d may be given for an additional 4 d if needed)
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, rate of administration for first
500 mL may be 2040 mL/min; thereafter, unless patient is hypovolemic, rate should not exceed 4 mL/min.
- Store at a constant temperature, preferably 25° C (77° F).
Adverse Effects (≥1%) All: Allergic reactions,
urticaria, wheezing, mild hypotension, nausea, vomiting, fever, arthralgia
, severe anaphylactoid
Volume expansion within minutes of infusion. Duration:
12 h. Metabolism:
Degraded to glucose and metabolized to carbon dioxide and water over a period of a few weeks. Elimination:
75% in urine within 24 h; small amount in feces.
Assessment & Drug Effects
- Observe closely for S&S of anaphylaxis (see Appendix F) especially during first 30 min of infusion. Severe reactions have
resulted in fatalities.
- Note: Bleeding time may be temporarily prolonged in patients receiving more than 1000 mL of dextran 70 or 75.
- Monitor I&O ratio and pattern. Monitor vital signs frequently as warranted by condition of patient.
Patient & Family Education
- Report immediately S&S of bleeding to physician: Easy bruising, blood in urine, or dark tarry stool.