18 YEARS OLD AND ABOVE
For intravenous use, the dosage and infusion rate are based on individual requirements and adapted to the patient's particular needs by monitoring the usual circulatory parameters.
The following dosage recommendations are approximate and apply to Adults:
Small volume losses and stabilisation of the circulation before and during surgery: 500 – 1000 ml. Larger volume losses, onset of shock: 1000 – 1500 ml.
Fully developed shock: up to 2500 ml and more, depending on the volume loss. The maximum rate of infusion is dependent on the state of the cardiac circulation. The rate of administration can be increased by the application of pressure to the container or by use of a giving set pump. Gelafusal should be previously warmed to the body temperature if it is to be administered by pressure infusion (pressure cuff, infusion pump). Since the symptoms of shock are not apparent until a volume loss at least 1000 ml has occurred, a rapid infusion with positive pressure within 10-15 minutes is recommended in such cases.
In emergencies with circulatory collapse: start with pressure infusion up to 500 ml; once the circulatory situation has improved, normal infusion depending on volume loss.
In order to detect the occurrence of anaphylactoid/anaphylactic reactions as early as possible the first 20-30 ml should be infused slowly and under careful observation.
The therapeutic limit (maximum daily dose) is determined by dilution effects. The haematocrit regarded as critical for a particular patient should decided on an individual basis and should be guided by the clinical situation. It is essential to watch for any dilution of plasma proteins (including clotting factors) and to ensure that they are replaced as required. There is a risk of overloading the circulation if the infusion is given too quickly.
The duration of treatment is determined by to the clinical situation.