Abstract
The use of plasma volume expanders for the prevention and treatment of shock has increased because of increased knowledge of the deleterious effect of plasma volume reduction. Several expanders of different types are available. Among them, clinical dextran has remarkable advantage, that is, it can be metabolized and has no effect of accumulation. However, as well as other expanders, clinical dextran has the deleterious effects such as sludging, prolongation of the bleeding time and allergy which are chiefly due to the high molecular weight fractions of dextran. Low molecular weight dextran has solved the deleterious effects of clinical dextran and moreover it has the superior effect on the peripheral blood flow which is due to disaggregation of aggregated blood cells and to reduction of whole blood viscosity.
The indication for the use of low molecular weight dextran has been found in the following condition: burns, crush injury and fat embolism, toxic shock, oliguria, thrombosis, acute arterial insufficiency, vascular surgery, extracorporeal circulation, large doses of roentgen contrast medium intravascularly. Infusions of low molecular weight dextran have not been followed by untoward reactions. Contraindications may be present in pulmonary edema, marked thrombocytopenia and localized septic processes.
