Introduction
Dextran 70 IV Infusion 6%+0.9% is a combination of a synthetic polysaccharide (Dextran) and an electrolyte solution (Sodium Chloride). It is commonly used in intravenous (IV) therapy to restore blood volume, maintain fluid balance, and treat hypovolemia or dehydration. Dextran acts as a plasma expander, while sodium chloride helps restore electrolyte balance.
Uses
This combination is primarily used for:
- Plasma expansion: To increase blood volume in cases of shock, trauma, burns, or surgical procedures.
- Fluid replacement: To treat or prevent dehydration and maintain fluid balance during IV therapy.
- Supportive treatment: In certain conditions like hypovolemia, hypotension, or blood loss.
| Brand Name | Dextran 70 |
|---|---|
| Type | IV Infusion |
| Weight | 6%+0.9% |
| Generic | Dextran + Sodium Chloride |
| Manufacturer | Institute of Public Health (IPH) |
| Available in | English বাংলা |
Mechanism of Action
Dextran increases plasma volume by acting as a colloid, which draws water from tissues into the bloodstream, thereby expanding the circulating blood volume. Sodium chloride maintains osmotic balance, replenishes electrolytes, and helps restore normal blood pressure. Together, they work to stabilize blood volume and pressure in patients experiencing fluid loss.
How Long Does It Take to Work?
The effects of Dextran 70 IV Infusion 6%+0.9% are typically seen within minutes after intravenous administration, as it rapidly increases plasma volume and helps improve circulation and blood pressure in patients.
Absorption
Dextran is administered intravenously and remains in the bloodstream, where it acts as a plasma expander. Sodium chloride is also administered intravenously and is distributed throughout the extracellular fluid. Dextran is not absorbed orally, so it is only given via IV.
Route of Elimination
Dextran is metabolized slowly in the body by enzymatic breakdown, with a portion excreted unchanged in the urine. Sodium chloride is excreted primarily by the kidneys through urine.
Dosage
Intrauterine-Aid in hysteroscopy:
- Adult: As dextran 70: 50-100 mL of a 32% solution instilled into the uterus as a rinsing and dilatation fluid.
Thromboembolic disorders:
- Adult: As dextran 40: Initially, 500 ml of a 10% solution in sodium chloride 0.9% or glucose 5% infused over 4-6 hr, followed by 500 ml infused over 4-6 hr on the next and subsequent alternate days for not more than 10 days.
- Child: As dextran 40: Up to 5 ml/kg in infants and 10 ml/kg in children.
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% or glucose 5% 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.
Prophylaxis of postoperative thromboembolic disorders:
- Adult: As dextran 40: 500 ml of a 10% solution in sodium chloride 0.9% or glucose 5% infused over 4-6 hr during or at the end of the surgery. Dose may be repeated the following day and treatment may be continued on alternate days for up to 10 days in high-risk patient.
- Child: As dextran 40: Up to 10 ml/kg in children.
Hypovolaemic shock:
- Adult: As dextran 40: Initially, 10 ml/kg given by rapid infusion as a 10% solution in sodium chloride 0.9% or glucose 5%. Doses may be given daily for up to 5 days. As dextran 70: Initially, 500-1000 mL of a 6% solution in sodium chloride 0.9% or glucose 5% infused at a rate of 20-40 mL/min. Maintenance: 10 ml/kg/day for3 days (Dextran 70).
The dosage of Dextran 70 IV Infusion 6%+0.9% varies depending on the patient's condition and medical requirements:
- Plasma volume expansion: The typical dose ranges from 500 to 1000 mL, administered as an IV infusion. For shock or severe blood loss, higher volumes may be necessary.
- Fluid maintenance: Lower doses may be given based on the patient’s needs and clinical condition.
Administration
Dextran 70 IV Infusion 6%+0.9% is administered via intravenous infusion, typically in a hospital or clinical setting under the supervision of healthcare professionals. The rate and volume of infusion depend on the patient's clinical condition, such as the severity of fluid loss or dehydration.
Side Effects
Common side effects include:
- Allergic reactions (e.g., rash, itching, difficulty breathing)
- Fluid overload, especially in patients with kidney or heart conditions
- Electrolyte imbalances
- Low blood pressure (hypotension) in some cases
Toxicity
Overdose of Dextran 70 IV Infusion 6%+0.9% can lead to volume overload, causing pulmonary edema, heart failure, or electrolyte imbalances such as hypernatremia (elevated sodium levels). In such cases, the infusion should be stopped immediately, and supportive care should be provided.
Precautions
Use caution in patients with:
- Kidney impairment
- Heart failure or cardiovascular conditions
- Electrolyte imbalances
- Known allergies to Dextran or Sodium Chloride
Interaction
Dextran 70 IV Infusion 6%+0.9% may interact with other intravenous fluids or medications, particularly those that affect fluid balance or electrolyte levels. It may enhance the effects of anticoagulants, so close monitoring of coagulation status is advised when used concurrently with anticoagulants.
Disease Interaction
Use with caution in patients with:
- Severe kidney disease
- Heart failure or pulmonary edema
- Hypertension
- Severe electrolyte imbalances (e.g., hypernatremia)
Drug Interaction
Potential drug interactions include:
- Anticoagulants: Dextran may enhance the anticoagulant effect, increasing the risk of bleeding.
- Diuretics: Caution is needed with diuretics as they may lead to electrolyte imbalances.
Food Interactions
There are no known significant food interactions with Dextran 70 IV Infusion 6%+0.9% since it is administered intravenously. Food intake does not affect its efficacy.
Pregnancy Use
There is limited data on the safety of Dextran 70 IV Infusion 6%+0.9% during pregnancy. It should be used only when clearly needed, and under the supervision of a healthcare provider, especially in cases of severe dehydration or fluid imbalance.
Lactation Use
Dextran 70 IV Infusion 6%+0.9% is generally considered safe for use during breastfeeding. However, it is essential to consult a healthcare provider to assess the risk-benefit ratio before use.
Acute Overdose
An acute overdose of Dextran 70 IV Infusion 6%+0.9% may lead to fluid overload, electrolyte disturbances, or cardiovascular complications. Treatment involves stopping the infusion and providing supportive care, including fluid and electrolyte management, and monitoring cardiac and renal function.
Contraindication
Dextran 70 IV Infusion 6%+0.9% is contraindicated in patients with:
- Known hypersensitivity to Dextran
- Severe kidney impairment or anuria (lack of urine production)
- Pulmonary edema or severe fluid overload
Use Direction
Dextran 70 IV Infusion 6%+0.9% should be administered only under the supervision of a healthcare professional, with careful monitoring of vital signs, fluid balance, and electrolyte levels. The infusion rate should be adjusted according to the patient’s clinical response.
Storage Conditions
Store Dextran 70 IV Infusion 6%+0.9% solution at room temperature, away from direct sunlight, heat, and freezing temperatures. Do not use if the solution is cloudy or contains particles.
Volume of Distribution
The volume of distribution for Dextran is confined mainly to the plasma compartment due to its colloid properties. Sodium chloride is distributed primarily in the extracellular space, including both the intravascular and interstitial compartments.
Half Life
The half-life of Dextran varies depending on its molecular weight. Low molecular weight Dextran (Dextran 40) has a half-life of approximately 2 to 3 hours, while high molecular weight Dextran (Dextran 70) has a half-life of about 6 to 8 hours. Sodium chloride has a rapid distribution and elimination, depending on renal function.
Clearance
Dextran is slowly metabolized and excreted by the kidneys. Sodium chloride is cleared by the kidneys and excreted in urine. Clearance rates depend on renal function and the patient’s fluid balance.
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