Following a fatality from renal shutdown in an 87-year-old patient receiving dextran 40, the authors have established a routine of administration based on individual variations in tolerance. This was successful in 75 subsequent patients, adjusting the hourly dosage of dextran 40 on the basis of hourly urine outputs and specific gravities. As long as the specific gravity remained under 1.030 and the hourly volume over 25 ml, the dosages were gradually increased up to a maximum of 50 ml/hr.
Thomas JM, Silva JR. Dextran 40 in the Treatment of Peripheral Vascular Diseases. Arch Surg. 1973;106(2):138–141. doi:10.1001/archsurg.1973.01350140006004
* * SCHEDULED MAINTENANCE * *
The JAMA Network Sites will be conducting routine maintenance from 10/20/2017 through 10/21/2017. During this window access to content and authentication may be intermittently available. The JAMA Store will be completely unavailable during the maintenance window.