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Dextran in major burns

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Dextran is a polymer of glucose. It is available in a variety of molecular weight solutions:

40,000 daltons; used more in the United States and thought to be the best at improving vascular dynamics by reducing red cell sludging
70,000 daltons; used more in Europe
150,000 daltons

One gram of dextran adsorbs at least 13 mls of water, at least twice the volume of an equivalent mass of non-colloid protein. Due to its osmotic properties, it increases urine output; 40% of dextran is excreted in the urine, the rest is metabolized. Hence, the urine output cannot be a reliable index of tissue perfusion in a patient resuscitated with dextran.

Disadvantages of dextrans include more allergic reactions and difficulty with blood grouping, particularly for the higher molecular weight solutions.

Typical infusion rates are 2mls/kg/hour.

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