Dextran / Sodium Chloride

What it is and how it works

Dextrans are glucose polymers of defined average molecular weight (e.g. dextran 40 or dextran 70) that exert colloid osmotic pressure and expand plasma volume. Low-molecular-weight dextran also reduces blood viscosity and platelet aggregation, improving microcirculatory flow.

Indications

Short-term expansion of plasma volume in hypovolaemia due to haemorrhage, burns, surgery or trauma; dextran 40 also for improving microcirculation and prophylaxis of thromboembolism in some surgical settings.

Dosage and administration (summary)

Dose and infusion rate are individualised according to the patient’s haemodynamic status and the dextran fraction, by intravenous infusion under medical supervision.

Contraindications

Known hypersensitivity to dextran, severe bleeding disorders or thrombocytopenia, severe heart failure, hypervolaemia, and renal failure with oliguria or anuria.

Warnings and precautions

Severe anaphylactoid reactions can occur, especially at the start of infusion; monitor closely and, where available, consider dextran 1 hapten prophylaxis. Dextran may interfere with blood grouping and cross-matching and some laboratory tests, so samples should be taken before infusion. Risk of fluid overload and acute kidney injury, particularly with dextran 40 in dehydrated patients.

Pregnancy

Use only if clearly necessary; anaphylactoid reactions in the mother may cause fetal distress.

Storage and supply

Store below 25 °C; do not freeze.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.