Clinical experience with 120,000 units of modified fluid gelatin.

We briefly review 20 years of clinical experience with 120.531 units of a 4% modified fluid gelatin as a plasma substitute. Its Mn is 22.500. The initial intravascular volume effect equals that of 4% albumin; the t0,5 of this effect is about 4 hours. It has no dosage-related side effects and specifically does not impair surgical hemostasis in volumes up to 10-15 litres within 24 hours. During the last 5 years, it has become an essential element of a blood component program, which has proven to be therapeutically satisfactory and logistically advantageous. More than 1000 patients have received more than 2000 ml within 24 hours as a part of massive transfusions. The incidence of serious anaphylactoid reactions has been 1 per 13,400 units, but only one fatality has occurred. At least one out of 7 "gelatin" reactions cannot have been caused by the colloid itself. These incidents were presumably due to trace contaminants. When compared to dextran, it appears that this gelatin is more prone to cause harmless cutaneous reactions, but less likely to induce severe cardiovascular incidents.