Medication Description: Polyglucin (Polyglucinum)
Sterile 6% solution of the weight fraction of partially hydrolyzed dextran (glucose polymer) in an isotonic solution of sodium chloride. Obtained by hydrolysis of native dextran, synthesized from sucrose, with the participation of a particular bacterial strain Leuconostoc mesenteroides.
Transparent colorless or slightly yellowish liquid. The average relative molecular weight is 60,000 + 10,000; relative viscosity 2, 8 4, 0; pH 4, 5 - 6, 5.
A similar product is available abroad under the names: Dextravan, Exxdex; Macrodex et al.
Polyglukin is a plasma-substituting anti-shock hemodynamic drug. Due to the relatively large relative molecular weight, close to that of blood albumin, polyglucin slowly penetrates through the vascular walls and, when injected into the bloodstream, circulates in it for a long time. Due to the high osmotic pressure exceeding about 2, 5 times the osmotic pressure of plasma proteins, polyglukin retains fluid in the bloodstream, thus exerting a hemodynamic effect.
Poliglyukin quickly increases blood pressure in acute blood loss and keeps it at a high level for a long time. The drug is non-toxic, mainly excreted by the kidneys (about 50% on the first day). A small amount is deposited in the reticuloendothelial system, where it gradually splits to glucose. The drug is not, however, a source of carbohydrate nutrition.
Polyglukin is used for prophylactic and therapeutic purposes in traumatic, operative and burn shock, acute blood loss, shock resulting from intoxication, sepsis, etc.
The drug is administered intravenously, and in acute blood loss, and intraarterially. The rate of administration is determined by the patient’s general condition, blood pressure level, pulse rate, hematocrit value.
With the developed shock, polyglukin is administered intravenously in a jet, usually using from 400 to 1200 ml per injection (and, if necessary, up to 2000 ml). When blood pressure rises to a level close to normal, they switch to drip. With blood loss of more than 500 ml and severe anemization of the patient, the introduction of polyglucine is combined with blood transfusion.
In order to prevent shock during operations, polyglukin is administered drip; in the event of a drop in blood pressure, they switch to jet injection. With a sharp decrease in pressure (below 60 mm Hg. Art.), Intraarterial administration of the drug is advisable (up to 400 ml). In the postoperative period, droplet injection of polyglucine 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, in the first 24 hours, up to 2000 ml of the preparation is injected, and in the next 24 hours up to 1500 ml. In the first 24 hours, children are prescribed 40-50 ml per 1 kg of body weight, and 30 ml / kg the next day.