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**λ±μ€νΈλ 70(Dextran 70)**μ μ£Όλ‘ **μ νλμ± μΌν¬**μ 보쑰 μΉλ£μ λ‘ μ¬μ©λλ κ³ λΆμλ ν©μ± μ½λ‘μ΄λμ λλ€. * **μμμ μν :** λΉκ΅μ μ λ ΄ν νμ₯ μ¦λμ λ‘ μ¬μ©λ©λλ€. νλ μμνμμλ **ν€νμ€νμΉ(Hetastarch)**κ° λ νν μ¬μ©λμ§λ§, λ±μ€νΈλ 70μ μ¬μ ν μ μν νκ΄ λ΄ μ©μ νμ₯μ μν μ ν¨ν μ νμ§μ λλ€. * **μ±λΆ:** νκ· λΆμλ 70,000 λ¬ν€μ λΆμ§ν λ€λΉλ₯μ λλ€. * **μμ μμ :** λΆμ ν¬κΈ°κ° 컀μ μ μ§μ‘(μ리μμΌμ λ±)λ³΄λ€ νκ΄ λ΄μ λ μ€λ λ¨Έλ¬ΌκΈ° λλ¬Έμ λλΆ μΈμ, ν μ’μ λλ νμκ° μΆνμ΄ μλ μ€μ¦ νμμ μλ μμμ μ λ§€μ° ν¨κ³Όμ μ λλ€.
μμ© κΈ°μ : **Dextran 70** exerts its effects through oncotic pull: * Acts as an artificial colloid β increases intravascular **colloid osmotic pressure (COP)**. * The high COP β draws fluid from the interstitial spaces into the vascular system. * This fluid shift β rapidly increases circulating blood volume β 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).
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- Small volume resuscitation (hypovolemic shock, head injury, pulmonary contusions, oliguric renal failure) Β· 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. Β· IV Β· As needed Β· Acute resuscitation Β· Reassess perfusion parameters between boluses.
- Volume expansion / Augment colloid oncotic pressure Β· 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. Β· IV Β· q24h or CRI Β· As needed Β· Reduces the volume of crystalloids infused, thereby reducing hemodilution.
- Dehydration secondary to diarrhea (Calves) Β· 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. Β· IV Β· Once Β· One time only Β· 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.
- Small volume resuscitation (hypovolemic shock, head injury, pulmonary contusions, oliguric renal failure) Β· 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. Β· IV Β· As needed Β· Acute resuscitation Β· Reassess perfusion parameters between boluses.
- Volume expansion / Augment colloid oncotic pressure Β· 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. Β· IV Β· q24h or CRI Β· As needed Β· Reduces the volume of crystalloids infused, thereby reducing hemodilution.
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- Preexisting severe coagulopathies
- Severe heart failure (due to risk of circulatory overload)
- Severe renal failure (oliguric/anuric, unless closely monitored)
- Intramuscular (IM) administration
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- 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)
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- 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
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**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.
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