Dextran 40 + Sodium Chloride is indicated in the following cases-

• Hypovolemic shock
• Weakness
• Source of calorie when needed
• Thrombosis
• Pulmonary embolism

Hypovolemic Shock

Weakness

Pulmonary Embolism

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.

Intravenous-
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.

Intravenous-
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.

Intravenous-
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.

Intravenous-
Hypovolemic 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)

Following side effects may appear-

• Congestive heart failure
• Mild hypotension
• Tightness of chest
• Thrombocytopenia
• Anaphylaxis
• Injection site infection/phlebitis
• Acute renal failure
• Acidosis (if NaCI soln used)
• Pulmonary edema
• Wheezing

Congestive Heart Failure (CHF)

Hypotension

Chest Tightness

Thrombocytopenia

Caution should be exercised in-

• Patients with or at risk of heart failure; active haemorrhage, diabetes mellitus, chronic liver failure, risk of pulmonary oedema.
• Renal and hepatic impairment. Pregnancy and lactation.

Correct dehydration prior to administration.

Not intended as a replacement for whole blood or blood components.