The dextrans--clinical data

Area of Science:

• Pharmacology
• Hemodynamics
• Resuscitation Medicine

Background:

• Dextrans are clinical colloids with plasma volume expansion, flow promotion, and antithrombotic effects.
• This discussion focuses on dextran's plasma volume and flow effects, excluding its antithrombotic properties.

Purpose of the Study:

• To elucidate the plasma volume expansion capabilities of dextrans compared to albumin and plasma proteins.
• To analyze the factors influencing plasma volume expansion, including dose, molecular weight, and elimination rate.
• To investigate the impact of dextrans on erythrocyte aggregation and blood flow dynamics.

Main Methods:

• Comparison of colloid-supported intravascular volume expansion (ml water/g colloid) for dextran 70, albumin, and plasma proteins.
• Evaluation of plasma volume expander effects in animal models.
• Assessment of dextran's influence on erythrocyte aggregation and blood flow.
• Experimental investigation into dextran's effects on kidney function.

Main Results:

• Dextran 70 demonstrates a high plasma volume expansion effect (approx. 20 ml/g), comparable to albumin (18 ml/g) and superior to plasma proteins (12-13 ml/g).
• Plasma volume expansion is dose-dependent and influenced by molecular weight distribution and intravascular clearance.
• Dextrans effectively counteract vasoconstriction in shock through plasma volume expansion, hemodilution, and improved erythrocyte aggregation.

Conclusions:

• Dextrans are effective plasma volume expanders with significant flow-promoting properties.
• The efficacy of plasma volume expanders depends on their ability to retain water intravascularly and their pharmacokinetic profiles.
• Dextrans play a vital role in managing shock by improving circulatory dynamics and counteracting vasoconstriction.