덱스트란 70
Dextran 70
Branched polysaccharide (Dextranum 70)
다른 이름: Gentran 70 · Macrodex · RescueFlow · Hyskon · Lomodex 70 · Longasteril 70 · Fisiodex 70 · dextranum 70 · polyglucin
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
소
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
덱스트란 70(Dextran 70)은 주로 저혈량성 쇼크의 보조 치료제로 사용되는 고분자량 합성 콜로이드입니다.
- 임상적 역할: 비교적 저렴한 혈장 증량제로 사용됩니다. 현대 수의학에서는 헤타스타치(Hetastarch)가 더 흔히 사용되지만, 덱스트란 70은 여전히 신속한 혈관 내 용적 확장을 위한 유효한 선택지입니다.
- 성분: 평균 분자량 70,000 달톤의 분지형 다당류입니다.
- 임상 요점: 분자 크기가 커서 정질액(생리식염수 등)보다 혈관 내에 더 오래 머물기 때문에 두부 외상, 폐 좌상 또는 폐쇄강 출혈이 있는 중증 환자의 소량 소생술에 매우 효과적입니다.
작용 기전
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).
안전성·주의사항
금기사항
- Preexisting severe coagulopathies
- Severe heart failure (due to risk of circulatory overload)
- Severe renal failure (oliguric/anuric, unless closely monitored)
- Intramuscular (IM) administration
부작용
- 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)
주의
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).
모니터링
- 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
약동학
흡수
After IV infusion, circulating blood volume is increased maximally within one hour and effects can persist for 24 hours or more.
분포
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.
대사
Slowly degraded to glucose by dextranase in the spleen, and then metabolized to carbon dioxide and water.
배설
A small amount may be excreted directly into the gut and eliminated in the feces.
과다투여
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.
제품
제형
- Injection: 6% dextran 70 in 0.9% sodium chloride (500 mL)
- Injection: 6% dextran 70 in 5% dextrose (500 mL)
인용의약품
- 6% dextran 70 in 0.9% sodium chloride injection (500 mL)
- 6% dextran 70 in 5% dextrose injection (500 mL)
규제 현황
규제 데이터 없음: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
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.
보호자 정보
응급 상황 전용: 덱스트란 70은 심각한 쇼크와 생명을 위협하는 저혈압을 치료하는 데 사용되는 병원 응급 약물입니다.
- 작용 원리: 반려동물의 혈관 내에서 스펀지처럼 작용하여 수분을 끌어당기고 유지함으로써 혈압과 혈액 순환을 빠르게 안정시킵니다.
- 모니터링: 위급한 상황에서 정맥으로 투여되므로, 수의료진은 반려동물의 심박수, 호흡, 혈압을 면밀히 모니터링하여 수액이 과다하게 투여되지 않고 잘 반응하는지 확인합니다.
- 부작용: 부작용은 드물지만 경미한 혈액 응고 변화나 아주 드물게 알레르기 반응이 나타날 수 있습니다. 수의사가 치료 기간 동안 이러한 증상을 주의 깊게 모니터링할 것입니다.
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