• Colloids are also referred to a plasma volume expanders

• Plasma volume expanders have a MW > 35,000

• Blood osmotic pressure is increased, & the blood volume is expanded by the volume infused & the passage of water from the intravascular space into the vascular bed

SPPS [stable plasma protein solution]

• Heat treated human plasma protein

• 5% solution of protein

• Protein is mainly albumin [86%]

• MW albumin 50,000 up to 200,000 for globulins

• Carries no risk of Hep B transmission

Indication:

• Resuscitation of shocked patients: especially in plasma loosing conditions eg burns, GIT obstructions & crush injuries

Cautions

• Hypotension may occur during rapid infusions due to bradykinnin-like substances; usually reversed by slowing infusion rate

Presentation

• SPPS 500ml; 50 g protein [86% albumin] per 1 litre

• Normal serum albumin 20% 100 ml

HAEMACCEL

• 3.5% gelatin prepared by hydrolysis of animal collagen

• MW 35-40,000

• Cheap & stable (shelf life 8 years)

• Relatively short intravascular half life (2-3 hours)

• Eliminated completely by hepatic metabolism & renal excretion

Indication:

• Prevention or treatment of shock associated with reduction in circulating blood volume due to: haemorrhage, vomiting, diarrhoea, plasma substitute during controlled haemodilution in surgery, extracorporeal circulation, loss of plasma [burns, crush injuries, peritonitis]

Cautions

• Rare cases of anaphylaxis with bronchospasm, hypotension & tachycardia [reaction due to histamine release—not a true anaphylactic reaction]

Presentation

• 500 ml

DEXTRAN

• Polysaccharides which have been fractionated into different molecular sizes

• Effective plasma expander with the increase in circulating volume persisting for several hours

• Has a colloid osmotic pressure greater than plasma

Indication:

• Prevention or treatment of shock associated with reduction in circulating blood volume due to: haemorrhage, vomiting, diarrhoea, loss of plasma [burns, crush injuries, peritonitis]

• Addition to prime in CPB

• Prophylaxis of postoperative & post-traumatic thromboembolism

Cautions

• The use of dextran to replace large volumes of plasma or blood loss should be limited to 1 litre, since no plasma components are being replaced

• Volumes > 1 litre may also interfere with haemostasis

• Contraindicated in DIC & thrombocytopaenia

Presentation

• Macrodex [Dextran 70 (av MW 70,000)]

• Rheomacrodex [Dextran 40 ( av MW 40,000)]