Dextran 70 + Sodium Chloride
Indications
Dextran 70 + Sodium Chloride is used for:
Peritonitis, Thromboembolic disorders, Hypovolaemic shock, Pulmonary embolism, Venous thrombosis, Open heart surgery, Paralytic ileus, Pancreatitis
Adult Dose
Intravenous
Hypovolaemic shock
Adult: As dextran 70: Initially, 500-1000 mL of a 6% solution in sodium chloride 0.9% infused at a rate of 20-40 mL/min. Maintenance: 10 ml/kg/day for3 days (Dextran 70).
Prophylaxis of pulmonary embolism or venous thrombosis in moderate- to high-risk patients undergoing surgery
Adult: As dextran 70: Initially, 500-1000 mL of a 6% solution in sodium chloride 0.9% infused over 4-6 hr during or immediately after surgery, followed by 500 mL on the next day and on subsequent alternate days for up to 2 wk after surgery in high-risk patients.
Intrauterine
As an aid in hysteroscopy
Adult: As dextran 70: 50-100 mL of a 32% solution instilled into the uterus as a rinsing and dilatation fluid.
Hepatic impairment: Extreme caution
Child Dose
Renal Dose
Extreme caution
Administration
Contra Indications
Allergy to corn products.
Precautions
May cause fluid and/or solute overload. Caution when used in patients with CHF, severe renal impairment or clinical conditions whereby there is sodium retention with oedema. Monitor serum potassium levels. Not to be administered concurrently with blood through the same infusion set due to risk of agglomeration. Patients with overt or known subclinical DM, or carbohydrate intolerance. Risk of hypokalaemia during parenteral admin of hypertonic dextrose solutions. Paediatric patients especially neonates and very low birth weight infants. Caution when used in patients receiving corticosteroids or corticotropin. Pregnancy.
Lactation: not known if distributed into breast milk, avoid
Pregnancy-Lactation
Interactions
Dextran: Enzyme inducers e.g. phenytoin or carbamazepine and enzyme inhibitors e.g. cimetidine.
Sodium Chloride: May affect serum concentrations of lithium.
Adverse Effects
Side effects of Dextran 70 + Sodium Chloride :
Congestive heart failure, Mild hypotension, Tightness of chest, Thrombocytopenia, Anaphylaxis, Injection site infection/phlebitis, Acute renal failure, Acidosis (if NaCl soln used), Pulmonary edema, Wheezing
Mechanism of Action
Dextrans produce expansion of plasma volume. It also reduces blood viscosity and inhibits sludging or aggregation of red blood cells.