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    Plasma Volume Expanders

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    Manoj Rameshkumar Mehta
    Plasma volume expanders are intravenous fluid solutions that increase plasma volume by raising osmotic pressure. They can be colloids like dextrans, gelatin, hydroxyethyl starch, or crystalloids like saline or dextrose. Colloids are preferred as they remain in circulation longer and are more effective at expanding volume. Plasma volume expanders work by drawing fluid into plasma from tissues via osmosis to replace lost blood and maintain blood pressure and tissue perfusion, especially in emergencies involving blood loss. The ideal properties of these expanders include exerting comparable oncotic pressure to plasma and remaining in circulation without leaking into tissues.

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    Plasma Volume Expanders

    Uploaded by

    Manoj Rameshkumar Mehta
    2K views17 pages
    Plasma volume expanders are intravenous fluid solutions that increase plasma volume by raising osmotic pressure. They can be colloids like dextrans, gelatin, hydroxyethyl starch, or crystalloids like saline or dextrose. Colloids are preferred as they remain in circulation longer and are more effective at expanding volume. Plasma volume expanders work by drawing fluid into plasma from tissues via osmosis to replace lost blood and maintain blood pressure and tissue perfusion, especially in emergencies involving blood loss. The ideal properties of these expanders include exerting comparable oncotic pressure to plasma and remaining in circulation without leaking into tissues.

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    pharmacology of plasma volume expanders

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    Plasma volume expanders

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    Plasma volume expanders are intravenous fluid solutions that increase plasma volume by raising osmotic pressure. They can be colloids like dextrans, gelatin, hydroxyethyl starch, or crystalloids like saline or dextrose. Colloids are preferred as they remain in circulation longer and are more effective at expanding volume. Plasma volume expanders work by drawing fluid into plasma from tissues via osmosis to replace lost blood and maintain blood pressure and tissue perfusion, especially in emergencies involving blood loss. The ideal properties of these expanders include exerting comparable oncotic pressure to plasma and remaining in circulation without leaking into tissues.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    2K views17 pages

    Plasma Volume Expanders

    Uploaded by

    Manoj Rameshkumar Mehta
    Plasma volume expanders are intravenous fluid solutions that increase plasma volume by raising osmotic pressure. They can be colloids like dextrans, gelatin, hydroxyethyl starch, or crystalloids like saline or dextrose. Colloids are preferred as they remain in circulation longer and are more effective at expanding volume. Plasma volume expanders work by drawing fluid into plasma from tissues via osmosis to replace lost blood and maintain blood pressure and tissue perfusion, especially in emergencies involving blood loss. The ideal properties of these expanders include exerting comparable oncotic pressure to plasma and remaining in circulation without leaking into tissues.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 17

    Plasma Volume Expanders

    Ms. Geetika Mehta


    Assistant Professor
    Pharmacology
    Plasma Volume Expanders
    Plasma volume expanders are the i.v. fluid solutions which
    increases the plasma volume by increasing osmotic pressure.
    • High molecular weight substances
    • Generally they are used to replace fluids that are lost due to
    illness, burns, trauma or hemorrhage.
    • In emergency, immediate volume replacement is important to
    maintain the blood pressure and tissue reperfusion.
    Plasma Volume Expanders
    Ideal properties of Plasma expanders
    • Exert oncotic pressure comparable to plasma
    • Should remain in circulation and not leak out in tissues, longer
    acting
    • Pharmacologically inert
    • Should be stable, easily sterilizable and cheap.
    • Should not interfere with grouping and crossmatching of blood.
    • Non –antigenic and non-pyrogenic
    Plasma Volume Expanders: Types
    Colloids Crystalloids
    • Dextrans
    • Normal saline
    • Gelatin
    • Hydroxymethyl starch • Dextrose
    • Polyvinylpyrrolodine • Ringer solution
    • Human albumin
    • Blood
    Plasma Volume Expanders
    Crystalloids are aqueous solutions of mineral salts or other
    water- soluble molecules while Colloids are larger insoluble
    molecules. Colloids are -
    • Longer acting
    • More expansive
    • The larger molecules of colloids are retained more easily in
    the intravascular space & increase osmotic pressure so more
    efficient than crystalloid.
    Mechanism of action
    • Generally works on the principle of osmosis.
    • increases plasma osmotic pressure, drawing water into plasma
    from intestinal fluid .
    • Since the lost blood is replaced with a suitable fluid, the
    diluted blood flows more easily, even in small vessels thus
    improve oxygen flux within the microcirculation
    Plasma volume expanders: Uses
    • used as plasma substitute in hypovolemic shock, burns and
    in extensive fluid loss- as an emergency measure to restore
    plasma volume.
    • Can also be used as a temporary measure in cases of whole
    blood loss till the same can be arranged
    Contraindications:
    Heart failure
    Severe anemia,
    Pulmonary edema
    Renal failure.
    DEXTRAN
    Dextrans are Polysaccharide obtained from sugar beat, and is available in
    two forms. Dextran-70 (MW 70,000), Dextran-40 (MW 40,000)
    Dextran 70
    • More commonly used, Osmotic pressure is similar to plasma.
    • Expands plasma volume for nearly 24 hours,
    • Slowly excreted by glomerular filtration as well as oxidized in the body
    over weeks.
    • It may interfere with coagulation, blood grouping and cross-matching
    • Allergic reactions are common
    DEXTRAN
    Dextran 40 – It is 10% solution of dextrose and saline.
    • Faster but shorter acting
    • It reduces blood viscosity and prevents RBC sludging : improves
    microcirculation
    • rapidly filtered at the glomerulus: and may get highly
    concentrated in the tubule if oliguria develops—tubular
    obstruction may occur
    • Dextrans can be stored for 10 years and are cheap.
    Degraded gelatin polymer (polygeline)
    • Synthetic polymer of MW-30,000
    • Doesn’t interfere with blood grouping and cross matching
    and is non-antigenic.
    • Duration of action :12 hrs.
    • Long shelf life
    • Used for priming the heart-lung and dialysis machines.
    Hydroxyethyl starch (Hetastarch)
    • It is a complex mixture of 90% ethoxylated amylopectin of various
    molecular sizes; average MW 4.5 lacs.
    • Maintains blood volume for longer time
    • Doesn’t cause acute renal failure or coagulation disturbances.
    • Improves hemodynamic status, stabilizes blood volume for 24 hrs.
    Adverse effects-
    Fever, chills, vomiting,
    anaphylactic reaction,
    urticaria may occur.
    Polyvinylpyrrolidone (PVP)
    • Synthetic water-soluble polymer, used as a 3.5% solution
    • Fraction of PVP is stored in reticuloendothelial cells, Kupfer
    cells in liver, skeletal muscles and skin for a long time
    • Partly excreted through kidneys
    • PVP binds penicillin and insulin in the plasma.
    • Not preferred- interfere with blood grouping and causes
    histamine release
    Human Albumin
    • Obtained from pooled human plasma
    • Given as 5% or 20% solution, 100 ml of 20% solution is
    osmotically equivalent to 800 ml of whole blood.
    • Nonantigenic, doesn’t interfere with coagulation and blood grouping
    • free of risk of transmission of hepatitis because the preparation is
    heat treated
    • Though expensive, can be used in burns, hypovolemic shock,
    hypoproteinaemia, acute liver failure and in dialysis.
    Normal Saline
    • Isotonic fluid, osmolarity nearly equal to that of ECF.
    • 0.9%sodium chloride
    • Remains in ECF, electrolytes make up its osmolarity
    • Used in Hyponatremia
    • Should be avoided in heart failure, pulmonary oedema and
    renal impairment- fluid overload
    DEXTROSE
    • Hypertonic fluid: used as 5% solution
    • Plasma volume expansion is minimum
    • Dextrose gets metabolised and water get distributed in all
    compartments
    • Infusion of 1litre of dextrose can raise the plasma volume by just
    100ml.
    • Should be injected slowly
    References
    1. KD Tripathi, ‘Essentials of Medical Phrmacology’, 8th
    edition, Jaypee Brothers Medical Publishers.
    2. Padmaja Udaykumar, ‘ Phrmacology for Pharmacy Students’,
    1st edition, CBS Publishers & Distributers Pvt.Ltd.
    THANK YOU

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