Dextran 40
Class: Replacement Preparations
VA Class: BL800
CAS Number: 9004-54-0
Brands: LMD
Introduction
Plasma volume expander; nonprotein colloid.
Uses for Dextran 40
Shock
Early fluid replacement and plasma volume expansion in the adjunctive treatment of certain types of shock or impending shock (e.g., burns, surgery, hemorrhage, or other trauma in which a circulating volume deficit is present) when whole blood or blood products are not available, or when the need for haste precludes the necessary cross-matching of blood.
Minimizes sludging of blood as a result of microcirculation effects.
Not a replacement for other forms of therapy; complementary to fluids and electrolytes.
Extracorporeal Circulation
Priming fluid (alone or as an additive to other priming fluids) in pump oxygenators for perfusion during extracorporeal circulation.
Prophylaxis of Thromboembolic Disorders
Prophylaxis of venous thrombosis and pulmonary embolism for surgical procedures associated with a high risk of thromboembolic complications (e.g., hip surgery).
May be beneficial in patients undergoing hip surgery; however, has not been shown to be more effective than oral anticoagulants or heparin in patients undergoing general surgery.
The American College of Chest Physicians (ACCP) does not recommend as sole method of thromboprophylaxis in elective hip arthroplasty.
Dextran 40 Dosage and Administration
Administration
IV Administration
For solution and drug compatibility information, see Compatibility under Stability.
Administer by IV infusion. Preservative-free, single-use container; discard unused portion.
Administer 20 mL dextran 1 before administration of dextran 40. (See Sensitivity Reactions under Cautions.)
When infusing concentrated dextran 40, use an administration set with a filter. An administration set is provided with commercially available preparation; consult the manufacturer’s instructions for proper use.
Prophylaxis of Thromboembolic Disorders
Generally, initiate dextran 40 therapy during the surgical procedure.
Rate of Administration
Shock
Infusion rate is dependent on patient-specific requirements (e.g., amount of fluid loss, resultant hemoconcentration). May infuse the first 500 mL (10 mL/kg) of solution rapidly if closely monitoring central venous pressure; however, infuse the remainder of the dose slowly. (See Circulatory and/or Volume Overload in Warnings.)
If not monitoring central venous pressure, infuse drug more slowly; closely observe patient for signs of circulatory overload.
Dosage
Pediatric Patients
Shock
IV
Adjust dosage and rate of infusion based on individual patient requirements, amount of fluid loss and resultant hemoconcentration. (See Rate of Administration under Administration.)
Infants: 0.5 g/kg (5 mL/kg).
Children: 1 g/kg (10 mL/kg).
Adolescents: Maximum total dosage (first 24 hours) of 2 g/kg (20 mL/kg); thereafter, maximum dosage of 1 g/kg (10 mL/kg) daily for...
