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.