Gelatin - instructions for use, doses, side effects, contraindications

Clinical and pharmacological group: & nbsp

Substitutes for plasma and other blood components

Included in the formulation

Geloplasmatic balance

solution d / infusion

Fresenius Kabi Deutschland GmbH Germany

Gelofusine

solution d / infusion

B. Brown Mehlungen AG Germany

Gelatinol®

solution d / infusion

SAMSON-MED, LLC Russia

Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):

VED

АТХ:

B.05.A.A.06 Preparations of gelatin

Pharmacodynamics:

Plasmo-replacing drug. Increases the volume of circulating blood, which leads to an increase in venous return and a minute volume of circulation, an increase in blood pressure, and an improvement in the perfusion of peripheral tissues. An increase in the volume of circulating blood and an increase in blood pressure occurs not only due to the injected solution, but also because of the additional interstitial fluid entering the vascular bed. Calling osmotic diuresis, it ensures the maintenance of kidney function in shock. Reduces the viscosity of blood, improves microcirculation. Due to its colloid-osmotic properties it prevents or reduces the likelihood of developing interstitial edema. Does not violate the protein, carbohydrate and pigment functions of the liver, improves microcirculation; accelerates erythrocyte sedimentation rate, which normalizes after 20 days on average. The volume-replacing effect is retained for 5 hours.

Pharmacokinetics:

Quickly leaves the bloodstream, which is explained by the presence of a large number of low molecular weight fractions (after 2 hours, approximately 20% of the injected drug remains in the blood). Half-life is 9 hours. 75% of the administered substance is excreted by the kidneys, 15% by the intestine. 10% of gelatin is cleaved in tissues through proteolysis and is included in protein metabolism. Do not cumulate.

Indications:

Prevention and treatment of hypovolemia in case of traumatic, burn, hemorrhagic and toxic shock; conditions accompanied by a thickening of the blood (for the purpose of hemodilution); extracorporeal circulation; preventive maintenance of depression of arterial pressure at a spinal or epidural anesthesia.

As a solvent when insulin is introduced (to reduce its loss due to adsorption on the walls of infusion tanks and tubes).

ICD-10

XIX.T79.T79.4 Traumatic shock

XVIII.R50-R69.R57.8 Other types of shock

XVIII.R50-R69.R57.1 Hypovolemic shock

IV.E70-E90.E86 Reduction of the volume of the liquid

Contraindications:

Hypervolaemia, severe chronic heart failure, hypersensitivity to gelatin. The drug is contraindicated in patients with acute and chronic nephritis.

Carefully:

With caution should be used in hyperhydration, chronic kidney failure, hemorrhagic diathesis, pulmonary edema, hypokalemia, hyponatremia.

Use with caution in elderly patients. The degree of reduction of hematocrit after administration of the drug should not exceed 25% in elderly patients.

Pregnancy and lactation:

The category of FDA recommendations is not defined. Adequate and well-controlled studies on humans and animals have not been conducted. There is no information on the penetration into breast milk.

The use of the drug during pregnancy and during lactation is possible only if the intended benefit to the mother exceeds the potential risk to the fetus and the baby.

Dosing and Administration:

The dosage regimen is set individually taking into account the severity of the plasma volume deficit.

Enter should be dripped intravenously. The duration of the infusion and the volume of the administered solution are determined taking into account the dynamics of heart rate, blood pressure, diuresis, perfusion state of peripheral tissues.

With moderate blood loss and with a prophylactic goal in the preoperative period or during the operation, they are administered in a dose of 0.5-1 L for 1-3 hours.

In the treatment of severe hypovolemia - 1-2 liters.

In emergency, life-threatening situations, 500 ml is injected in the form of fast infusion (under pressure), then after an improvement in blood circulation, the infusion is performed in an amount equivalent to a volume deficit.

To maintain the volume of circulating blood in shock, the infusion volume can reach 10-15 liters per day.

For extracorporeal circulation requires 0.5-1.5 liters of solution (depending on the system used).

Side effects:

From the side of the cardiovascular system: hypocoagulation caused by the effect of dilution (with a large volume of infusion).

Bleeding is due to the dilution of clotting factors.

Allergic reactions: anaphylactoid reactions.

In case of adverse reactions, stop the infusion immediately and insert antihistamine, vasoconstrictors and glucocorticosteroids, vasopressor drugs used in the treatment of anaphylactic shock without removing needles from the vein.

Overdose:

Symptoms of hemodilution. Treatment is symptomatic.

Interaction:

Pharmaceutically incompatible with vancomycin - precipitation of white precipitate, as well as with fatty emulsions, barbiturates, muscle relaxants, other antibiotics,glucocorticosteroids.

Compatible with solutions of electrolytes, carbohydrates, whole blood.

Special instructions:

It can change the indicators of diagnostic tests for glucose, fructose, cholesterol, fatty acids, as well as the rate of erythrocyte sedimentation, the specific gravity of urine, and urinary protein (including the biuret method).

Turbulent solutions do not use. Before the gelatin transfusion, the physician must perform a visual inspection of the infusion bottles. The preparation is considered suitable for use provided that the sealing is kept tight, there is no cracks on the bottles. The drug should be clear and not contain suspended matter. The results of visual inspection of bottles and label data (name of the drug, manufacturer, serial number) must be recorded in the patient's medical history.

The degree of decrease in hematocrit should not exceed 25% (in the elderly, as well as in cardiovascular and pulmonary insufficiency - 30%). In chronic heart failure, infusion is slow because of possible circulatory overload. With the introduction of more than 2-3 liters in the postoperative period, it is necessary to monitor the concentration of protein in the blood serum,especially in the presence of edema of tissues (if necessary for the further plasma-substituting therapy, it is advisable to administer human albumin).

When used as an infusion under pressure (cuff of the tonometer, infusion pump), the solution must be heated to body temperature. When the drug is administered under pressure, all air from the vial must be removed beforehand.

Instructions

Gelatin (Gelatina)