Description of the medicine: Polyglucin (Polyglucinum)
A sterile 6% solution of the molecular weight fraction of partially hydrolyzed dextran (glucose polymer) in an isotonic sodium chloride solution. Obtained by hydrolysis of native dextran synthesized from sucrose with the participation of a specific strain of bacteria Leuconostoc mesenteroides.
Transparent, colorless or slightly yellowish liquid. The average relative molecular weight of 60,000 + 10,000; relative viscosity 2, 8 4, 0; pH 4, 5 - 6, 5.
A product similar in properties is produced abroad under the names: Dextravan, Exrandx; Masrodex et al.
Polyglukin is a plasma-replacing antishock drug with hemodynamic effects. Due to the relatively large relative molecular weight close to that of blood albumin, polyglucin slowly penetrates through the vascular walls and, when introduced into the bloodstream, circulates in it for a long time. Due to the high osmotic pressure, which is approximately 2.5 times the osmotic pressure of blood plasma proteins, polyglucin retains fluid in the bloodstream, thus exerting a hemodynamic effect.
Polyglukin quickly increases blood pressure in acute blood loss and keeps it at a high level for a long time. The drug is non-toxic, excreted mainly by the kidneys (about 50% on the first day). A small amount is deposited in the reticuloendothelial system, where it is gradually broken down to glucose. The drug is not, however, a source of carbohydrate nutrition.
Polyglucin is used for prophylactic and therapeutic purposes in case of traumatic, surgical and burn shock, acute blood loss, shock as a result of intoxication, sepsis, etc.
The drug is administered intravenously, and with acute blood loss and intra-arterial. The rate of administration is determined by the general condition of the patient, the level of blood pressure, pulse rate, and hematocrit.
In case of developed shock, polyglucin is administered intravenously, usually from 400 to 1200 ml per infusion (and if necessary up to 2000 ml). With an increase in blood pressure to a level close to normal, they switch to drip administration. With blood loss of more than 500 ml and severe anemization of the patient, the introduction of polyglucin with blood transfusion is combined.
In order to prevent shock during operations, polyglucin is administered dropwise; in the event of a drop in blood pressure, they switch to jet administration. With a sharp decrease in pressure (below 60 mm Hg. Art.), Intra-arterial administration of the drug is advisable (up to 400 ml). In the postoperative period, jet-drop administration of polyglucin is an effective way to prevent postoperative shock. Children are prescribed at the rate of 10 - 15 ml per 1 kg of body weight.
For the treatment of burn shock, up to 2000 - 3000 ml of the drug is administered in the first 24 hours, and up to 1500 ml in the next 24 hours. In the first 24 hours, children are prescribed 40-50 ml per 1 kg of body weight, the next day - 30 ml / kg.