Polygeline

Summary

Polygeline (Haemaccel) is a 3.5% solution of cross-linked urea-bridged gelatin polypeptide derived from bovine collagen, used as an intravenous plasma volume expander for the treatment of hypovolemia, shock, and as a priming fluid for cardiopulmonary bypass. It has a mean molecular weight of approximately 35,000 Da and a relatively short intravascular half-life compared to other colloids.

Mechanism of Action

Polygeline is a cross-linked gelatin polypeptide that acts as a colloidal plasma expander. It increases intravascular oncotic pressure, thereby drawing fluid into the vascular compartment and expanding plasma volume. It remains in the circulation long enough to restore blood pressure and tissue perfusion in hypovolemic states.

Routes of Administration

Goals & Uses

• Perioperative volume maintenanceAnesthesia / Perioperative CareModerate
• Hypovolemia treatmentHemodynamic StabilizationModerate
• Hemorrhagic shock resuscitationEmergency MedicineModerate
• Cardiopulmonary bypass primingCardiac SurgeryModerate

Contraindications

• Renal failure with oliguria/anuriaRenalModerate
• Simultaneous administration with blood through same lineDrug/fluid CompatibilityModerate
• Known hypersensitivity to gelatin or polygelineAllergyHigh
• Hypervolemia or congestive heart failureCardiovascularHigh
• Severe hypercalcemiaElectrolyte DisorderModerate

Adverse Effects

• Anaphylactoid/anaphylactic reactionImmunologicUncommon
• Fluid overload / pulmonary edemaCardiovascular/respiratoryUncommon
• Coagulation disturbancesHematologicUncommon
• Urticaria and pruritusDermatologicUncommon
• HypotensionCardiovascularUncommonLow blood pressure
• Electrolyte imbalanceMetabolicUncommonAbnormal blood electrolyte levels

Drug Interactions

• AminoglycosidesLow
• Cardiac glycosides (e.g., digoxin)Moderate
• Citrate-anticoagulated blood productsHigh

Population Constraints

• Pediatric patientsAgeRelative
• Patients with pre-existing coagulopathyHematologicRelative
• Patients with bovine gelatin allergy or known sensitizationAllergyAbsolute
• Pregnant womenReproductiveRelative

Regulatory Status

• European UnionApprovedApproved: Hypovolemia, Plasma volume expansionAvailable in several EU member states; regulatory status varies by country.
• United StatesUnapprovedNot FDA-approved; not commercially available in the United States.
• United KingdomApprovedApproved: Hypovolemia, Hemorrhagic shock, Plasma volume expansion, Cardiopulmonary bypass primingMarketed as Haemaccel; approved for use as a plasma substitute.

Approved and marketed in several countries (e.g., UK, India, parts of Europe and Asia) as Haemaccel. Not FDA-approved in the United States. Use has declined in some regions due to concerns about anaphylactoid reactions and questions about clinical outcomes compared to crystalloids.

Evidence & Sources

No sources recorded yet.