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Dextran is a medication used in managing and treating various clinical conditions, including during hemorrhage, shock, surgical procedures, radiological imaging, antithrombotic administration, and ophthalmic relief of xerophthalmia. This activity reviews the indications, contraindications, adverse events, mechanisms of action, toxicity, and other key factors of dextran therapy in the clinical setting, related to the essential information needed by members of a professional healthcare team in the treatment and management involved in patient care with the related conditions. Objectives: Identify the mechanism of action of dextran. Assess the potential adverse effects of dextran. Evaluate the appropriate monitoring for patients receiving therapy with dextran. Outline several interprofessional team strategies for improving care coordination and communication to advance dextran and improve outcomes. Access free multiple choice questions on this topic.

Renal effects of dextran toxicity are due to the increased serum viscosity, especially in patients with oliguria. A low specific gravity of urine during therapy can suggest a failure of the kidneys to clear dextran, so patients require assessment for hydration during administration and signs of dehydration before the onset of acute renal failure.[14] As previously mentioned, patients with advanced renal disease are especially prone to suffering from worsening renal function. Hepatic effects of dextran toxicity may include elevated liver function test results, particularly increased AST and ALT levels, most commonly observed in patients undergoing surgery or cardiac catheterization. This occurs because dextran accumulates in hepatocytes, where it is metabolized; excessive levels can induce hepatic oxidative stress, contributing to liver injury.[15]

The polysaccharide dextran has versatile applications as a colloid in enhancing patient care and improving healthcare team outcomes. It can rapidly replace plasma volume losses in conditions of severe hypovolemia, especially during uncontrolled hemorrhage when compatible whole blood or blood products are not yet available.[1] Furthermore, dextran is also used as an antithrombotic agent, an intravenous radiotracer, and in ophthalmic solutions.[2][3] Adverse reactions to dextran are generally uncommon, largely due to careful monitoring by the interprofessional healthcare team, including clinicians, advanced practitioners, nurses, and pharmacists. When reactions do occur, they may involve cardiac, renal, hepatic, hematologic, or anaphylactic responses. Proactive monitoring for signs of toxicity is essential to enhance patient safety and minimize complications. Achieving this requires coordinated efforts across all disciplines, rather than reliance on a single provider. Collaborative oversight ensures improved therapeutic outcomes with a reduced risk of adverse effects.