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1/10/14

Volume Expanders

Volume expanders include albumin, dextran, and hetastarch. Often the term colloid is used to refer to all volume expanders.

Protein solutions: Albumin, plasma, and commercial plasmas (e.g., Plasmanate).
Dextran: Complex, synthetic sugar, metabolized slowly, does not stay in the vascular space as long as a colloid.
Hetastarch: Synthetic colloid that works similarly to Dextran.

Volume Expanders (Colloids)

Solution
Components
Indications
Albumin
5% and 25%
Human plasma
protein
5%—To expand
volume and
mobilize interstitial
edema
25%—To treat
hypoproteinemia
Plasma
Plasmanate
Plasma protein
fraction (PPF)
Contains human
plasma proteins
in NS
To increase serum
colloid osmotic
pressure
Dextran
40 and 70
Synthetic colloid
made of glucose
polysaccharides
To expand volume
To mobilize
interstitial edema
Hetastarch
Hespan
Synthetic colloid
made from corn
To expand volume
To mobilize
interstitial edema


Blood and Blood Products
Product
Components
Indications
Whole Blood
Contains all blood
products
Rarely used may be
given emergently to
an exsanguinating
patient
Packed Red
Blood Cells
(PRBCs)
No clotting factors
or platelets, 80%
plasma removed
To treat acute and
chronic anemia,
blood loss
Platelets
Usually given in
pools of 6–10
units
To increase low
platelet counts or
treat coagulopathies
One unit will
generally increase
platelet count by
6000 units
Fresh Frozen
Plasma
(FFP)
Plasma and
clotting factors
To replace clotting
factors, e.g., after
multiple transfusions
(>6 units PRBCs), or
to reverse the effects
of Coumadin
Cryoprecipitate
Clotting factors
To treat hemophilia,
fibrinogen deficiency,
DIC

Autologous Blood Donation/Transfusion
A procedure for collecting and storing a Pt’s own blood several weeks before its anticipated need by the Pt.
Salvage of blood normally lost during a surgical procedure.

Used to prevent the transmission of disease from donor blood. It is not without risk: stored blood may still become contaminated.

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