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    Plasma Expanders

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    sumit kumari
    Plasma expanders are substances that increase blood volume by exerting osmotic pressure. They are classified as colloids or crystalloids. Colloids like dextran, hydroxyethyl starch, and gelatin remain in circulation longer than crystalloids like saline and dextrose. An ideal plasma expander expands volume, remains in circulation for adequate time, and is excreted without side effects. They are used to treat hypovolemic shock, burns, trauma, and endotoxin shock. Contraindications include anemia, heart failure, and kidney issues.

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    Plasma Expanders

    Uploaded by

    sumit kumari
    50 views14 pages
    Plasma expanders are substances that increase blood volume by exerting osmotic pressure. They are classified as colloids or crystalloids. Colloids like dextran, hydroxyethyl starch, and gelatin remain in circulation longer than crystalloids like saline and dextrose. An ideal plasma expander expands volume, remains in circulation for adequate time, and is excreted without side effects. They are used to treat hypovolemic shock, burns, trauma, and endotoxin shock. Contraindications include anemia, heart failure, and kidney issues.

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    Plasma Expanders[1]

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    Plasma expanders are substances that increase blood volume by exerting osmotic pressure. They are classified as colloids or crystalloids. Colloids like dextran, hydroxyethyl starch, and gelatin remain in circulation longer than crystalloids like saline and dextrose. An ideal plasma expander expands volume, remains in circulation for adequate time, and is excreted without side effects. They are used to treat hypovolemic shock, burns, trauma, and endotoxin shock. Contraindications include anemia, heart failure, and kidney issues.

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    © All Rights Reserved
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    50 views14 pages

    Plasma Expanders

    Uploaded by

    sumit kumari
    Plasma expanders are substances that increase blood volume by exerting osmotic pressure. They are classified as colloids or crystalloids. Colloids like dextran, hydroxyethyl starch, and gelatin remain in circulation longer than crystalloids like saline and dextrose. An ideal plasma expander expands volume, remains in circulation for adequate time, and is excreted without side effects. They are used to treat hypovolemic shock, burns, trauma, and endotoxin shock. Contraindications include anemia, heart failure, and kidney issues.

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    of 14

    PLASMA

    EXPANDERS
    PRESENTED BY: MS. SUMIT KUMARI
    NURSING TUTOR
    SION
    Plasma expanders
    Plasma expanders are high mol. Wt. substances
    which when infused IV exert osmotic pressure
    and remain in the body for a long time to
    increase the volume of circulating fluid
    a. Colloids
    1. Dextran
    2. Polyvinylpyrrolidine
    3. Gelatin polymers
    4. Hydroxyethyl starch
    b. Crystalloids
    5. Normal saline
    6. Dextrose
    7. Dextrose Saline
    Requirements of an ideal plasma expander:
    1. Oncotic pressure comparable to plasma.
    2. Remain in the circulation for an adequate period and
    3. Disposed of either by metabolic degradation or by
    excretion.
    4. Not antigenic or pyrogenic.
    5. Not interfere with grouping and cross matching of
    blood.
    USE OF PLASMA EXPANDERS:
    • Hypovolemic shock.
    • Burns.
    • Severe trauma.
    • Endotoxin shock.

    Contraindications:
    • Severe anaemia.
    • Cardiac failure.
    • Pulmonary oedema.
    • Renal insufficiency.
    Colloidal plasma expanders
     Substances of high Mol.Wt.
     Remain long time in blood stream
     Augment the volume of circulating fluid
     By increasing the osmotic pressure
    DEXTRAN:
     It is a Polysaccharide[ made of
    many glucose molecules].
     Dextran 70 (MW – 70,000) & Dextran 40 ( MW –
    40,000).
     Oncotic pressure similar to plasma proteins and expands
    plasma volume for about 24 hours.
     Large doses do not induce antibody formation.
     They may interfere with coagulation and platelet
    function and also blood grouping.
     Dextran – 70: Excreted very slowly by glomerular
    filtration and some amount deposited in RE cells.
    Dextran – 40: Reduces blood viscosity.
     Excreted through renal tubules and

    occasionally may produce acute renal failure.


    Precautions should be taken.
    Caution:
     Dextran does not provide necessary electrolytes

    and can cause hyponatremia or


    other electrolyte disturbances
    DEXTRAN- OTHER USES:
     Antithrombotic in microsurgeries
      In some eye drops as a lubricant
      To solubilize other factors, e.g. iron (iron dextran)
     Used in laboratory tests

    Contraindications:
     Allergy.
     Heart failure.
     Acute oliguric renal failure.
     Hypofibrinogenemia.
     Thrombocytopenia
    Hydroxyethyl starch[HES]:
    Compared to dextrans –
     Maintains blood volume longer.
     Does not cause acute renal failure or coagulation

    disturbances.
    Adverse effects:
     Anaphylactoid reactions
     Mild fever, Chilling, periorbital edema, urticaria,

    itching and chills.


    POLYVINYLPYRROLIDONE[PV
    P]:
     Synthetic polymer,MW- 40,000.
     Interferes with blood grouping and cross
    matching.
     Releases histamine.
     Binds to penicillin and insulin
    Gelatin polymer[Haemaccel]:
     Does not interfere with grouping and cross

    matching.
     Expands plasma volume for about 12 hours.
     Not antigenic
     Hypersensitivity and hypotension can

    occur.
    CRYSTALLOIDS
    Normal saline:
    Very limited duration of action.
    Dextrose:
     Osmolality is lower than serum.
     Useful when kidney function is impaired.
     Human albumin:
     Obtained from pooled human plasma.
     Crystalloid solutions must be infused concurrently

    for better action.


     Does not interfere with coagulation.
     Used as a vehicle for transfusing packed red cells.
    Thank You

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