TREATMENT OF SHOCK WITH DEXTRANS AND GELATINS - EFFECTS AND SIDE EFFECTS

Summary. The effects and side effects of dextran and gelatin plasma substitutes relevant to the treatment of shock are reviewed. The physico‐chemical characteristics give the dextrans a certain lead over the gelatins with respect to molecular weight, intravascular volume effect and retention period. Experimental studies and clinical experience, however, have failed to demonstrate any difference of their therapeutic value, as revealed by survival data and suppression of shock‐induced metabolic alterations. Severe allergic reactions may occur with dextrans, but have not so far been recorded with gelatins. Hemostatic impairment limits the tolerated dose of clinical dextran, the risk of renal damage that of low molecular weight dextran. Similar side effects of the gelatins have not been documented. The risk of overtransfusion is greater with dextrans than with gelatins. The lower potency of the gelatins would appear, therefore, to be at least outweighed by their freedom from side effects, which enlarges the therapeutic margin of safety for shock treatment with artificial colloids. © 1969 Blackwell Publishing Ltd