Plasma substitutes

Plasma substitutes, which are also called blood substitution products, can be made up of natural or artificial substances. They are used to compensate for a fall in circulating blood volume. They are particularly used in hypovolaemic or haemorrhagic shock (with loss of more than 50% of the total blood volume).

Do they have contraindications or precautions?

Hypovolaemia may occur after a haemorrhage but also from dehydration, anaphylactic shock and burns which have destroyed large surface areas of skin. The plasma substitutes are also used to prevent thrombosis (the formation of one or more blood clots) which may occur after a procedure such as orthopaedic surgery. There are four available subcategories of plasma substitutes:

• hydroxyethyl starch;
• human albumin;
• dextrans ;
• gelatins.

Sources:

• Merck Manual – 4^th edition
• WHO prescriber information template forms: Medicines used in anaesthesia, website accessed on 15 June 2011