デキストラン70
Dextran 70
Branched polysaccharide (Dextranum 70)
別名: Gentran 70 · Macrodex · RescueFlow · Hyskon · Lomodex 70 · Longasteril 70 · Fisiodex 70 · dextranum 70 · polyglucin
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Small volume resuscitation (hypovolemic shock, head injury, pulmonary contusions, oliguric renal failure) | 5 mL/kg over 1-5 minutes (after initial isotonic crystalloids 10-15 mL/kg). Repeat as needed until end-point of resuscitation is reached. | IV | As needed | Acute resuscitation | 🌎 NA |
| Volume expansion / Augment colloid oncotic pressure | 20 mL/kg/day; when acute resuscitation is required, may be given as a slow bolus over 30 minutes to an hour. May also be given as a constant rate infusion. | IV | q24h or CRI | As needed | 🌎 NA |
- Small volume resuscitation (hypovolemic shock, head injury, pulmonary contusions, oliguric renal failure): Reassess perfusion parameters between boluses.
- Volume expansion / Augment colloid oncotic pressure: Reduces the volume of crystalloids infused, thereby reducing hemodilution.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Small volume resuscitation (hypovolemic shock, head injury, pulmonary contusions, oliguric renal failure) | 2-5 mL/kg over 1-5 minutes (after initial isotonic crystalloids 5-10 mL/kg). Repeat as needed until end-point of resuscitation is reached. | IV | As needed | Acute resuscitation | 🌎 NA |
| Volume expansion / Augment colloid oncotic pressure | 10 mL/kg/day; when acute resuscitation is required. May be given as a slow bolus over 30 minutes to an hour. May also be given as a constant rate infusion. | IV | q24h or CRI | As needed | 🌎 NA |
- Small volume resuscitation (hypovolemic shock, head injury, pulmonary contusions, oliguric renal failure): Reassess perfusion parameters between boluses.
- Volume expansion / Augment colloid oncotic pressure: Reduces the volume of crystalloids infused, thereby reducing hemodilution.
牛
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Dehydration secondary to diarrhea (Calves) | 4-5 mL/kg over 4-5 minutes of a 6% dextran 70 in 7.2% NaCl solution. Follow immediately by oral administration of isotonic electrolyte solution. | IV | Once | One time only | 🌎 NA |
- Dehydration secondary to diarrhea (Calves): To prepare: add 31.6 g NaCl to 60 mL syringe, draw 60 mL of 6% dextran 70 in 0.9% NaCl, dissolve, and filter through 0.22 micron filter. Give ONE TIME ONLY to avoid hypernatremia.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
デキストラン70は、主に循環血液量減少性ショックの補助治療に使用される高分子量の合成コロイドです。
- 臨床的役割： 比較的安価な血漿増量剤として機能します。現代の獣医療ではヘタスターチ（および新しいテトラスターチ）がより一般的に使用されていますが、デキストラン70は依然として迅速な血管内ボリューム拡張のための有効な選択肢です。
- 組成： 平均分子量70,000ダルトンの分岐多糖類です。
- 臨床のポイント： 分子が大きいため、晶質液（乳酸リンゲル液や生理食塩水など）よりも長く血管内に留まり、頭部外傷、肺挫傷、または閉鎖腔出血を伴う重症患者の少量蘇生に非常に効果的です。
作用機序
Dextran 70 exerts its effects through oncotic pull:
- Acts as an artificial colloid → increases intravascular colloid osmotic pressure (COP).
- The high COP → draws fluid from the interstitial spaces into the vascular system.
- This fluid shift → rapidly increases circulating blood volume → improves venous return, cardiac output, and systemic perfusion.
- Note: Dextran 70 has a colloid osmotic pressure of 62 mmHg, which is significantly higher than normal canine plasma (approx. 20 mmHg).
安全性・警告
禁忌
- Preexisting severe coagulopathies
- Severe heart failure (due to risk of circulatory overload)
- Severe renal failure (oliguric/anuric, unless closely monitored)
- Intramuscular (IM) administration
有害事象
- Increased bleeding times (decreased von Willebrand's factor and factor VIII activity)
- Anaphylactoid reactions (rare in dogs, but higher incidence than hetastarch)
- Acute renal failure (rare)
- Volume overload / circulatory overload
- Gastrointestinal effects (nausea, vomiting, abdominal pain - reported in humans)
注意事項
Critical Warnings:
- Circulatory Overload: Use with extreme caution in patients susceptible to volume overload (e.g., severe cardiac or renal disease).
- Coagulation: Can interfere with platelet function. Use cautiously in patients with thrombocytopenia.
- Sodium Load: A 500 mL bag of 6% dextran 70 in normal saline contains 77 mEq of sodium. Use cautiously in patients requiring strict sodium restriction.
Laboratory Interferences:
- Cross-matching: May interfere with blood cross-matching by causing red blood cell cross-linking (rouleaux formation). Washing cells with isotonic saline can negate this.
- Blood Glucose: Levels may falsely increase as dextran is degraded into glucose.
- Bilirubin: May cause falsely elevated bilirubin levels (mechanism unknown).
監視
- Perfusion parameters (heart rate, blood pressure, capillary refill time, mucous membrane color)
- Signs of fluid/circulatory overload (respiratory rate/effort, lung sounds)
- Coagulation status / bleeding times (if prolonged use or high doses)
- Renal function and urine output
薬物動態
吸収
After IV infusion, circulating blood volume is increased maximally within one hour and effects can persist for 24 hours or more.
分布
Approximately 20-30% of a given dose remains in the intravascular compartment at 24 hours. It may be detected in the blood 4-6 weeks after dosing.
代謝
Slowly degraded to glucose by dextranase in the spleen, and then metabolized to carbon dioxide and water.
消失
A small amount may be excreted directly into the gut and eliminated in the feces.
過剰投与
Volume Overload: Overdosage primarily results in circulatory/fluid overload. The drug must be dosed and monitored carefully. Treatment is supportive, potentially requiring diuretics (e.g., furosemide) if severe pulmonary edema or volume overload occurs.
製品
製剤
- Injection: 6% dextran 70 in 0.9% sodium chloride (500 mL)
- Injection: 6% dextran 70 in 5% dextrose (500 mL)
ヒト用医薬品
- 6% dextran 70 in 0.9% sodium chloride injection (500 mL)
- 6% dextran 70 in 5% dextrose injection (500 mL)
規制ステータス
規制データなし: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Store at room temperature, preferably in an area with little temperature variability. Only clear solutions should be used. If dextran flakes form, they may be resolubilized by heating the solution in a boiling water bath until clear, or by autoclaving at 110°C for 15 minutes.
飼主向け情報
救急専用： デキストラン70は、重度のショックや生命を脅かす低血圧の治療に使用される病院用の救急薬です。
- 働き： ペットの血管内でスポンジのように働き、水分を引き込んで保持することで、血圧と血液循環を迅速に安定させます。
- モニタリング： 危機的な状況で静脈内投与されるため、獣医療チームはペットの心拍数、呼吸、血圧を注意深く監視し、適切な反応を示しているか、水分過多になっていないかを確認します。
- 副作用： 副作用はまれですが、血液凝固のわずかな変化や、ごくまれにアレルギー反応が含まれる場合があります。獣医師は治療中これらの兆候を監視します。
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