Intravenously sprayed, drip-drip and drip.
Doses and the speed of administration of the drug should be selected individually in accordance with the indications and the patient's condition, the value of blood pressure, heart rate, hematocrit.
Immediately before the application of dextran, with the exception of urgent conditions, a skin test is performed.
The intradermal test is carried out 24 hours before the infusion of the drug. For this purpose, 0.05 ml of the preparation is injected intradermally with the formation of lemon crust on the inside of the forearm, shoulder or other area accessible for visual evaluation of the skin test. The doctor evaluates the reaction after 24 hours.
The presence of redness on the injection site, the formation of a papule or the appearance of symptoms of a general reaction in the form of nausea, dizziness, or other manifestations 10-15 minutes after injection indicates an increased sensitivity of the patient to the drug and the impossibility of using the drug in this patient. In the absence of any reactions, the patient is given the required amount of the preparation of the series that was used to conduct the intradermal test. The results of the sample are recorded in the medical history.
It should be remembered that the skin test does not allow to reveal sensitization to dextran in 100% of patients. Therefore, in the first 5-10 minutes as the intravenous drug is administered in each case, it is necessary to closely monitor the patient's condition.
In the case of emergency conditions, when applying the drug, it is necessary to conduct a bioassay: after the slow introduction of the first 5 dropsthe drug is stopped for 3 minutes, then another 30 drops are added and the infusion is stopped again for 3 minutes. In the absence of a reaction, continue the injection. The results of the bioassay are necessarily recorded in the medical history.
1. If capillary blood flow is disturbed (various forms of shock), intravenously drip or drip-drop, at a dose of 0.5 to 1.5 liters, until the hemodynamic parameters stabilize at the life-supporting level. If necessary, the amount of drug coins to be increased to 2 liters.
Children with various forms of shock are administered at the rate of 5-10 ml / kg, the dose can be increased if necessary to a maximum of 15 ml / kg. It is not recommended to reduce the hematocrit value below 25%.
2. In cardiovascular and plastic surgeries, intravenous drip is administered intravenously, just before surgery, for 30-60 minutes to adults and children at a dose of 10 ml / kg, during an operation, adults - 500 ml, children - 15 ml / kg.
After the operation, the drug is administered intravenously drip (within 60 minutes) for 5-6 days at the rate of:
adults - 10 ml / kg once;
children up to 2-3 years - 10 ml / kg once a day;
children up to 8 years - 7-10 ml / kg 1-2 times a day;
children under 13 years - 5-7 ml / kg 1-2 times a day.
For children over 14 years of age doses are the same as for adults.
3. In operations with artificial circulation, the drug is added to the blood at the rate of 10-20 ml / kg of the patient's body weight to fill the oxygenator pump. The concentration of dextran in the perfusion solution should not exceed 3%. In the postoperative period, the doses of the drug are the same as for a violation of capillary blood flow.
4. For the purpose of detoxification, intravenously drip in a single dose of 500 to 1250 ml (in children 5-10 ml / kg) for 60-90 minutes. If necessary, you can introduce another 500 ml of the drug in the first day (in children the administration of the drug in the first day can be repeated in the same doses). In the following days, the drug is administered drip, adults - in a daily dose of 500 ml, children - at a rate of 5-10 ml / kg.