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The antithrombotic efficacy of dextran.
1Department of Surgery, Karolinska Institutet, Danderyd Hospital, Sweden.
Acta Chirurgica Scandinavica. Supplementum
|January 1, 1988
Summary
Dextran effectively prevents thrombo-embolism, especially in orthopedic surgery, and can replace initial blood loss without disease transmission risks. Its use offers reduced bleeding complications compared to heparin, with minimal anaphylaxis risk.
Area of Science:
- Medical Science
- Pharmacology
Background:
- Dextran introduced in 1944 as a plasma substitute.
- Established prophylactic agent against postoperative thrombo-embolism since 1962.
Purpose of the Study:
- Evaluate dextran's efficacy and safety in thrombo-embolism prophylaxis.
- Compare dextran with low-dose heparin (LDH) in general and orthopedic surgery.
Main Methods:
- Review of clinical data on dextran and heparin use.
- Comparison of deep-vein thrombosis (DVT) and pulmonary embolism (PE) prevention rates.
- Assessment of complication risks, including bleeding and anaphylaxis.
Main Results:
- Dextran is superior to LDH in preventing DVT in orthopedic surgery.
- Dextran and LDH show similar efficacy in preventing fatal PE.
- Dextran infusion replaces initial blood loss (500-800 ml) without disease transmission.
- Dextran prophylaxis has a lower risk of hemorrhagic complications than heparin.
- Severe anaphylaxis risk with dextran is minimal (1:40,000) due to hapten inhibition.
Conclusions:
- Dextran is a safe and effective agent for thrombo-embolism prophylaxis, particularly in orthopedic procedures.
- Dextran offers advantages over heparin, including reduced bleeding risk and disease transmission avoidance.
- Modern dextran formulations with hapten inhibition significantly minimize anaphylaxis risk.