Gelofusine

Gelofusin has a plasma-substituting effect, and in addition it improves microcirculation processes.

[1], [2], [3],

Indications of the gelofusine

Applies to such violations and in such cases:

• hypovolemia  (developing due to a shock that is traumatic or hemorrhagic, operating loss, sepsis, or burns);
• to prevent the decrease in the level of pressure (during the introduction of spinal anesthesia);
• hemodilution;
• artificial perfusion (during the process of hemodialysis, and in addition, the device heart-lungs).

[4], [5], [6]

Release form

The drug is produced in the form of a 4% infusion solution, inside the bottles of polyethylene with a capacity of 0.5 liters.

[7], [8], [9], [10]

Pharmacodynamics

Gelofusine is a 4% solution, which is a modified gelatin. It has a 100% vollemic effect, lasting for 3-4 hours, and depends on the rate of excretion of the colloid. The size of the maximum daily dose during the administration is 0.2 l / kg, and in the case of very severe bleeding, it is required to administer 10-15 liters of medication per day.

The solution allows replacing the volume of previously lost intravascular fluid, due to which there is an increase in the values of blood pressure and systolic volume, and in addition, an increase in diuresis. Volemicheskoe impact is equivalent to the amount of intravenous drug.

The drug lowers the viscosity of the blood, which improves the microcirculation process; as a result of its use, interstitial puffiness disappears. In addition, the drug has pronounced detoxification properties.

Has no negative effect on the process of hemostasis, it can be used for persons with kidney failure.

The use of Gelofusin does not lead to replenishment of the level of proteins.

[11], [12], [13]

Pharmacokinetics

After the procedure of administration, the drug undergoes a rapid distribution in the intravascular medium; Only a small part of it penetrates into the interstitial space. Inside the macrophage system, the drug is not delayed.

Approximately 95% of the medicament is excreted through the kidneys, and another 5% through the intestine. Only 1% of the substance is exposed to metabolic processes. Small molecules are excreted by renal filtration, and large molecules undergo a process of degradation within the liver, and then excreted with the participation of the kidneys.

Proteolytic metabolic process is easy, accumulation of gelatin does not develop even in people with kidney failure.

The half-life of drugs from the vascular bed is 4-5 hours. This indicator is slightly lengthened in people who are on hemodialysis.

[14], [15], [16]

Dosing and administration

It is necessary to administer the medication intravenously. The size of the daily portion and the duration of the procedure of administration are determined taking into account the patient's condition, as well as disorders of the circulatory processes that need to be adjusted. To detect possible allergies, you should slowly inject 20 ml of the drug under the supervision of a doctor.

During elimination of plasma or hemorrhage of a moderate nature, 0.5-1 L of drug substance is administered.

With the development of severe degree of hypovolemia, 1-2 l of preparation is necessary.

With artificial perfusion, the dose is 0.5-1 L of LS.

The size of the maximum allowable daily portion is determined by the degree of severity of hemodilution. In case of severe blood loss, a transfusion of up to 10 l / day may be necessary.

With a decrease in hematocrit to values below 25%, transfusion of whole blood is required, after which the Gelofusin administration procedure is allowed to continue.

[22], [23]

Use of the gelofusine during pregnancy

There is no information about the presence of any embryotoxic properties in Gelofusin.

Because the risk of the appearance of allergic symptoms (anaphylactoid or anaphylactic nature) can not be excluded, it is necessary to prescribe the solution to pregnant women only in situations where the probable benefit for a woman is more expected than the appearance of negative consequences in the fetus.

There is no information about the passage of the medicine inside the mother's milk.

Contraindications

The main contraindications:

• the presence of high sensitivity in relation to the action of the drug;
• hypervolemia;
• heart failure in severe degree;
• problems with the processes of coagulation, having a pronounced form;
• water poisoning.

Caution is necessary when using drugs with people with disorders of coagulation function, hypernatremia, kidney deficiency, dehydration, and in addition with chronic forms of hepatic pathology, against which coagulation factors are noted.

[17], [18], [19]

Side effects of the gelofusine

Use of the drug may lead to the appearance of such side effects:

• development of urticaria and the occurrence of rashes on the skin;
• a sharp decrease in blood pressure;
• stopping the respiratory process;
• shock state;
• abdominal pain or nausea;
• increase in temperature.

With the development of such manifestations, the medication should be discontinued immediately.

[20], [21]

Overdose

Poisoning manifests itself in the form of circulatory overload with an existing liquid. Because of this, pulmonary edema and the failure of the CCC function develop. Overload leads to the fact that the left heart ventricle loses its ability to eject blood volume inside the aorta.

When such violations occur, it is necessary to stop the administration of drugs and appoint a patient to take diuretics.

[24]

Interactions with other drugs

The drug has compatibility with electrolyte solutions, glucose, and whole blood.

Gelofusin is incompatible with GCS, barbiturates, and in addition fatty emulsions, and in addition muscle relaxants and antibiotics.

[25], [26], [27], [28]

Storage conditions

Gelofusine should be kept at temperature levels within the range of 8-25 ° C.

[29],

Shelf life

Gelofusin is allowed to be used for 3 years from the date of manufacture of the drug solution.

Application for children

Information regarding the efficacy and safety of the drug for persons under the age of 18 years is not available.

[30], [31], [32], [33], [34], [35], [36]

Analogues

Gelofusin has the following medicinal analogues: Geloplazma, Modegel, and Gelatinol.

[37], [38], [39], [40],

Reviews

It is believed that in cases of severe blood loss, the use of drugs that have minimal haemostasis effect is most appropriate: among such medicines, hydroxyethyl starch-based drugs (such as Infukol, Refortan, and Stabisol), and a gelatin-based gelofusin drug.

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

It is known that Gelofusin is more effective in improving microcirculation processes than that of hydroxyethyl starch. In this regard, he is considered the medicine of choice in the case 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 in patients about what specific infusion treatment was performed by them in intensive care after a surgical operation.