右旋糖酐 70
Dextran 70
Branched polysaccharide (Dextranum 70)
別名: Gentran 70 · Macrodex · RescueFlow · Hyskon · Lomodex 70 · Longasteril 70 · Fisiodex 70 · dextranum 70 · polyglucin
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
右旋糖酐 70 (Dextran 70) 是一種高分子量合成膠體，主要用於低血容性休克的輔助治療。
- 臨床作用： 它是一種成本相對較低的血漿體積擴充劑。雖然現代獸醫學中更常使用羥乙基澱粉 (Hetastarch)，但右旋糖酐 70 仍是快速擴充血管內體積的有效選擇。
- 成分： 它是一種平均分子量為 70,000 道爾頓的支鏈多醣。
- 臨床要點： 由於其分子較大，它在血管內停留的時間比晶體輸液（如乳酸林格氏液或生理食鹽水）更長，因此對於頭部外傷、肺挫傷或閉合性體腔出血的重症病患進行小體積復甦非常有效。
作用機制
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).
安全性與警告
禁忌症
- Preexisting severe coagulopathies
- Severe heart failure (due to risk of circulatory overload)
- Severe renal failure (oliguric/anuric, unless closely monitored)
- Intramuscular (IM) administration
不良反應
- 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).
監測
- 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
藥物動力學
吸收
After IV infusion, circulating blood volume is increased maximally within one hour and effects can persist for 24 hours or more.
分佈
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.
排除
A small amount may be excreted directly into the gut and eliminated in the feces.
過量
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.
可用產品
劑型
- Injection: 6% dextran 70 in 0.9% sodium chloride (500 mL)
- Injection: 6% dextran 70 in 5% dextrose (500 mL)
人用標示
- 6% dextran 70 in 0.9% sodium chloride injection (500 mL)
- 6% dextran 70 in 5% dextrose injection (500 mL)
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
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.
飼主須知
僅供急診使用： 右旋糖酐 70 是一種醫院急救藥物，用於治療嚴重的休克和危及生命的低血壓。
- 作用原理： 它在寵物的血管內就像一塊海綿，將水分吸入並保留在血管中，從而迅速穩定血壓和血液循環。
- 監測： 由於它是在危急情況下透過靜脈注射給予，您的獸醫團隊將密切監測寵物的心跳、呼吸和血壓，以確保牠們反應良好且沒有發生體液過載。
- 副作用： 副作用很少見，但可能包括輕微的凝血功能改變，或者在極少數情況下出現過敏反應。您的獸醫會在治療期間密切監控這些情況。
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