Gelofusine

Gelofusin has a plasma-substituting effect and also improves microcirculation processes.

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Indications Gelofusina

It is used for such disorders and in such cases:

• hypovolemia (developing due to shock of a traumatic or hemorrhagic nature, surgical loss, sepsis or burns);
• to prevent a decrease in blood pressure (during the administration of spinal anesthesia);
• hemodilution;
• artificial perfusion (during the hemodialysis process, and also in the heart-lung device).

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Release form

The medication is released in the form of a 4% infusion medicinal solution, inside polyethylene bottles with a capacity of 0.5 l.

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Pharmacodynamics

Gelofusin is a 4% solution, which is a modified gelatin. It has a 100% volemic effect, lasting for 3-4 hours, and depending on the rate of excretion of the colloid. The maximum daily dose during administration is 0.2 l/kg, and in case of very severe bleeding, it is necessary to administer up to 10-15 l of the drug per day.

The solution allows replacing the volume of previously lost intravascular fluid, due to which the values of blood pressure and systolic volume increase, and in addition, diuresis increases. The volemic effect is equivalent to the amount of the drug administered orally.

The drug reduces blood viscosity, thereby improving the microcirculation process; as a result of its use, interstitial edema disappears. In addition, the drug has pronounced detoxifying properties.

It does not have a negative effect on the hemostasis process and can be used by people with kidney failure.

The use of Gelofusine does not lead to replenishment of protein levels.

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Pharmacokinetics

After the administration procedure, the drug undergoes rapid distribution in the intravascular environment; only a small part of it penetrates into the interstitial space. The drug is not deposited inside the macrophage system.

Approximately 95% of the drug is excreted through the kidneys, and another 5% through the intestines. Only 1% of the substance undergoes metabolic processes. Small molecules are excreted by renal filtration, and large ones undergo a process of degradation in the liver, after which they are excreted with the participation of the kidneys.

The proteolytic metabolic process is carried out easily, and gelatin accumulation does not develop even in people with kidney failure.

The half-life of the drug from the vascular bed is 4-5 hours. This indicator is slightly extended in people undergoing hemodialysis.

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Dosing and administration

The medication must be administered intravenously. The daily dose and the duration of the administration procedure are determined taking into account the patient's condition, as well as the circulatory disorders that need to be corrected. To detect a possible allergy, 20 ml of the drug should be administered slowly under the supervision of a doctor.

When eliminating moderate plasma or blood loss, 0.5-1 liter of the drug is administered.

If severe hypovolemia develops, it is necessary to administer 1-2 liters of the drug.

With artificial perfusion, the dose size is 0.5-1 l of the drug.

The maximum daily dose is determined by the degree of hemodilution. In case of severe blood loss, transfusion of up to 10 l/day may be required.

If the hematocrit decreases to values below 25%, a whole blood transfusion is required, after which the Gelofusin administration procedure can be continued.

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Use Gelofusina during pregnancy

There is no information about Gelofusin having any embryotoxic properties.

Since the risk of allergic symptoms (anaphylactoid or anaphylactic nature) cannot be excluded, the solution should be prescribed to pregnant women only in situations where the probable benefit to the woman is more expected than the occurrence of negative consequences for the fetus.

There is no information on the passage of the drug into breast milk.

Contraindications

Main contraindications:

• the presence of high sensitivity to the action of the drug;
• hypervolemia;
• severe heart failure;
• problems with coagulation processes that have a pronounced form;
• water poisoning.

Caution is required when using the drug by people with coagulation function disorders, hypernatremia, renal failure, dehydration, and also with chronic forms of liver pathologies, against which coagulation factor disorders are observed.

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Side effects Gelofusina

Use of the drug may result in the following side effects:

• development of urticaria and the appearance of a rash on the skin;
• a sharp decrease in blood pressure values;
• cessation of the respiratory process;
• state of shock;
• abdominal pain or nausea;
• increase in temperature.

If such manifestations develop, you must immediately stop administering the drug.

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Overdose

Poisoning manifests itself as circulatory overload with the available fluid. This causes pulmonary edema and CVS function failure. The overload causes the left ventricle to lose its ability to eject blood volume into the aorta.

If such violations occur, it is necessary to stop the administration of the drug and prescribe the patient to take diuretics.

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Interactions with other drugs

The drug is compatible with electrolyte solutions, glucose, and whole blood.

Gelofusin is incompatible with GCS, barbiturates, and also fat emulsions, as well as muscle relaxants and antibiotics.

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Storage conditions

Gelofusin should be kept at temperatures between 8-25°C.

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Shelf life

Gelofusin can be used for 3 years from the date of manufacture of the medicinal solution.

Application for children

There is no information regarding the effectiveness and safety of the drug for persons under 18 years of age.

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Analogues

Gelofusin has the following medicinal analogues: Geloplasma, Modell, and Gelatinol.

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Reviews

It is believed that in case of severe blood loss, the most appropriate is the use of drugs that have a minimal hemostatic effect - among such drugs are hydroxyethyl starch-based drugs (such as Infucol, Refortan, and Stabizol) and a gelatin-based drug - Gelofusin.

Among the advantages of the latter are pronounced volemic properties, absence of negative impact on renal/hepatic activity and hemostasis processes. In addition, the drug has a pronounced detoxifying effect and does not cause allergic symptoms (although their development can be expected).

It is known that Gelofusin is more effective in improving microcirculation processes than hydroxyethyl starch medications. In this regard, it is considered the drug of choice in cases of large-scale blood loss and is constantly used in emergency cases.

The drug receives few reviews - most likely, this is due to the lack of information among patients about what specific infusion treatment was given to them in intensive care after surgery.