Gelaspan (Succinylated Gelatin)
Plasma volume expander — solution for intravenous infusion
Gelaspan is a plasma volume expander (colloid solution) containing succinylated gelatin, used to replace blood and body fluids lost during surgery, trauma, or burns. Administered intravenously in hospital settings by healthcare professionals, Gelaspan works by exerting colloidal osmotic pressure to retain fluid in the bloodstream. It is only used when crystalloid solutions alone are considered insufficient for restoring adequate circulating blood volume.
Quick Facts
Key Takeaways
- Gelaspan is a gelatin-based colloid solution used to replace lost blood volume in surgical, trauma, and burn settings when crystalloid solutions alone are insufficient.
- It must not be used in patients with gelatin allergy, alpha-gal (red meat) allergy, hypervolemia, acute congestive heart failure, or severe hyperkalemia.
- All plasma volume expanders carry a small risk of anaphylactic reactions, which are more likely in patients with known allergic conditions such as asthma.
- Gelaspan contains a balanced electrolyte composition (sodium, potassium, calcium, magnesium, chloride, acetate) to help maintain acid-base homeostasis.
- Dosage is individualized based on the patient's blood loss, hemodynamic status, and clinical condition, and is always administered under medical supervision in a healthcare facility.
What Is Gelaspan and What Is It Used For?
Gelaspan belongs to a class of medicines known as plasma volume expanders (also called colloid solutions). These solutions are designed to replace fluid lost from the blood circulation and to maintain adequate blood volume and blood pressure in critically ill or surgical patients. Unlike crystalloid solutions such as normal saline or Ringer’s lactate, which distribute rapidly into the spaces between cells, colloid solutions like Gelaspan contain large molecules (succinylated gelatin) that remain in the bloodstream for a longer period, exerting colloidal osmotic pressure that draws and retains fluid within the intravascular space.
The active substance in Gelaspan is succinylated gelatin (also known as modified liquid gelatin), a polydisperse polypeptide derived from bovine collagen through a controlled degradation and chemical modification process. Each 1000 mL of Gelaspan solution contains 40 g of succinylated gelatin along with a carefully balanced mixture of electrolytes including sodium (151 mmol/L), chloride (103 mmol/L), potassium (4 mmol/L), calcium (1 mmol/L), magnesium (1 mmol/L), and acetate (24 mmol/L). This balanced electrolyte composition is designed to closely mimic the ionic content of human plasma and help maintain the body’s acid-base balance during fluid resuscitation.
Gelaspan is indicated for the following clinical situations:
- Volume replacement: To replace blood and body fluids lost as a result of surgery, traumatic injury, or burn injuries. It can be used in combination with blood transfusion when needed.
- Prevention of hypotension: To prevent low blood pressure (hypotension) that may occur during spinal or epidural anesthesia, or when there is a risk of significant blood loss during surgical procedures.
- Cardiopulmonary bypass: In combination with other infusion fluids to increase the circulating blood volume during procedures that use a heart-lung machine (cardiopulmonary bypass).
It is important to understand that Gelaspan is only used when treatment with crystalloid solutions alone is not considered sufficient to maintain adequate circulating blood volume. Healthcare providers carefully assess each patient’s clinical status, hemodynamic parameters, and degree of blood loss before deciding to administer Gelaspan. The European Society of Intensive Care Medicine (ESICM) and other international guidelines recommend a balanced approach to fluid resuscitation, using crystalloids as the first-line treatment and adding colloids such as gelatin-based solutions when additional volume expansion is required.
The volume-expanding effect of Gelaspan is approximately equal to the volume infused and lasts for 3 to 4 hours, after which the gelatin molecules are broken down and excreted primarily by the kidneys. This makes Gelaspan suitable for short-to-medium-term volume resuscitation in acute clinical settings.
What Should You Know Before Receiving Gelaspan?
Contraindications
Gelaspan must not be administered to patients in the following circumstances:
- Allergy to gelatin or any other ingredient in the solution (see composition section)
- Alpha-gal allergy: Allergy to the allergen galactose-alpha-1,3-galactose (alpha-gal), or confirmed allergy to red meat (mammalian meat) and offal. Alpha-gal syndrome is an emerging allergic condition linked to tick bites (particularly the Lone Star tick in the Americas and Ixodes ricinus in Europe) that causes sensitivity to mammalian-derived products, including gelatin.
- Hypervolemia: Excessive circulating blood volume
- Fluid overload: Excess fluid accumulation in body tissues
- Acute congestive heart failure: A specific type of heart failure where the heart cannot pump effectively
- Hyperkalemia: Abnormally high potassium levels in the blood
Due to the risk of potential cross-reactivity, Gelaspan must not be given to patients with known allergy to red meat or mammalian offal, or those who have tested positive for IgE antibodies against the alpha-gal allergen. These patients may experience severe anaphylactic reactions.
Warnings and Precautions
Healthcare providers exercise particular caution when administering Gelaspan to patients with the following conditions, as large volumes of intravenous fluid may worsen these states:
- Cardiac disease: Pre-existing heart conditions, including coronary artery disease and valvular heart disease, may be aggravated by rapid volume expansion.
- Hypertension: High blood pressure may increase further with volume loading.
- Pulmonary edema: Fluid in the lungs may worsen, potentially causing respiratory distress.
- Severe renal impairment: Impaired kidney function may reduce the body’s ability to excrete excess fluid and gelatin molecules, leading to fluid accumulation.
- Allergic conditions: Patients with known allergic diseases such as asthma are at increased risk of developing allergic reactions to gelatin solutions. Close monitoring is essential, especially at the beginning of the infusion.
Additional precautions apply in the following situations:
- Hypernatremia or hyperchloremia: Significantly elevated sodium or chloride levels in the blood require cautious use, as Gelaspan contains substantial amounts of both electrolytes.
- Edema: Patients with tissue swelling caused by fluid and salt retention need careful monitoring during infusion.
- Coagulation disorders: Patients with significantly impaired blood clotting ability require close surveillance, as gelatin solutions can further dilute coagulation factors.
- Elderly patients: Older patients may have reduced cardiac and renal reserve, making them more vulnerable to fluid overload.
During treatment with Gelaspan, healthcare providers monitor blood composition including hemoglobin levels, hematocrit, electrolytes, and coagulation parameters. The hematocrit should not fall below 25% (or 30% in elderly or critically ill patients). Additional fluids, electrolytes, or blood products may be administered as needed based on these laboratory values.
Blood samples for blood grouping and antibody screening should ideally be drawn before Gelaspan infusion, as certain test results may be affected. Gelaspan can produce falsely elevated results in erythrocyte sedimentation rate (ESR), urine specific gravity, and nonspecific protein assays (e.g., biuret method).
Use in Children
There is limited clinical experience with the use of Gelaspan in pediatric patients. Healthcare providers only administer this medication to children when it is deemed absolutely necessary for the child’s clinical recovery. When used in children, the clinical condition is carefully assessed, and the treatment is monitored with particular vigilance. Dosing is adjusted based on the child’s weight and clinical status.
Pregnancy and Breastfeeding
Pregnancy: The use of Gelaspan should be avoided during pregnancy due to the potential risk of allergic reactions, which could be harmful to both the mother and the fetus. However, in life-threatening emergency situations, healthcare providers may administer Gelaspan when the benefit to the mother clearly outweighs the potential risk to the unborn child.
Breastfeeding: There is limited information available on whether succinylated gelatin or its metabolites are excreted in human breast milk. The treating physician will make a clinical decision about whether to discontinue breastfeeding or to withhold Gelaspan treatment, weighing the benefits of breastfeeding for the infant against the benefits of treatment for the mother.
Fertility: No human or animal studies have evaluated the effects of Gelaspan on fertility. However, based on the pharmacological properties of succinylated gelatin and the other ingredients, it is considered unlikely that fertility would be affected.
How Does Gelaspan Interact with Other Drugs?
Healthcare providers carefully consider potential drug interactions before administering Gelaspan. The most clinically significant interactions involve medications that affect fluid balance and electrolyte homeostasis. Because Gelaspan contains sodium (151 mmol/L), concurrent use with drugs that promote sodium retention can lead to tissue edema (swelling in the arms, hands, legs, and feet).
Significant Drug Interactions
| Drug Class | Examples | Interaction Effect | Clinical Significance |
|---|---|---|---|
| ACE Inhibitors | Captopril, Enalapril, Lisinopril | Sodium retention leading to peripheral edema | Monitor for fluid overload |
| Potassium-sparing Diuretics | Spironolactone, Triamterene, Amiloride | Risk of hyperkalemia and sodium retention | Monitor potassium levels closely |
| Corticosteroids | Cortisone, Prednisolone, Hydrocortisone | Sodium and water retention, increased edema risk | Monitor fluid balance |
| NSAIDs | Diclofenac, Ibuprofen, Naproxen | Sodium retention, reduced renal perfusion | Monitor fluid balance and renal function |
| Potassium-losing Diuretics | Furosemide, Hydrochlorothiazide | May alter electrolyte balance | Monitor electrolytes during co-administration |
No compatibility studies have been conducted. Gelaspan must not be mixed with any other medicinal products. It must not be infused through the same infusion line as blood or blood products (packed red blood cells, plasma, or plasma fractions).
Healthcare providers always review the patient’s complete medication list before initiating Gelaspan infusion. This includes prescription medications, over-the-counter drugs, and herbal supplements. The electrolyte content of Gelaspan (particularly potassium at 4 mmol/L) is an important consideration in patients already receiving drugs that affect potassium balance, such as potassium-sparing diuretics, ACE inhibitors, or potassium supplements.
What Is the Correct Dosage of Gelaspan?
Gelaspan is administered exclusively by intravenous infusion (IV drip) by qualified healthcare professionals in a clinical setting. The dose, infusion rate, and duration of treatment are determined individually based on the patient’s degree of blood or fluid loss, overall clinical condition, and hemodynamic parameters (blood pressure, heart rate, central venous pressure). Healthcare providers perform regular monitoring tests, including blood tests and blood pressure measurements, throughout the infusion and adjust the dose accordingly.
Adults
Standard Dosing
The amount of Gelaspan and the duration of infusion depend on the volume of blood or fluid lost and the patient’s clinical status. The physician continuously monitors hemodynamic parameters and laboratory values to guide dosing. Blood or packed red blood cells may be administered concurrently when clinically indicated.
Emergency / Pressure Infusion
In acute, life-threatening hemorrhagic situations, Gelaspan may be administered by pressure infusion, with 500 mL given over 5–10 minutes until clinical signs of hypovolemia resolve. When using pressure infusion, all air must be removed from the container and infusion set before administration to avoid the risk of air embolism. The solution may be warmed to a maximum of 37°C prior to infusion.
Children
Pediatric Dosing
Clinical data on the use of Gelaspan in children are limited. This medication is only administered to pediatric patients when deemed essential for the child’s recovery. Dosing takes into account the child’s body weight, clinical condition, and hemodynamic status. Treatment is monitored with particular vigilance in the pediatric population.
Elderly Patients
Geriatric Considerations
Elderly patients may have reduced cardiac reserve and renal function, making them more susceptible to fluid overload. The physician prescribes Gelaspan with particular caution in this age group. The hematocrit should not fall below 30% in elderly or critically ill patients (compared to 25% in younger adults). Close hemodynamic monitoring is essential.
Overdose
An overdose of Gelaspan can cause hypervolemia (excessive blood volume) and fluid overload, which may impair cardiac and pulmonary function. Symptoms of overdose may include headache, breathing difficulties (dyspnea), elevated blood pressure, and signs of pulmonary edema. In the event of overdose, the infusion is immediately discontinued, and the physician initiates appropriate supportive measures, which may include diuretic therapy to remove excess fluid.
When compensating for severe blood loss with large volumes of Gelaspan, hematocrit and electrolyte values must be closely monitored. The dilution effect on coagulation factors should also be observed, particularly in patients with pre-existing hemostatic disorders. Plasma protein concentrations should be monitored, as Gelaspan does not replace lost plasma proteins.
What Are the Side Effects of Gelaspan?
Like all medicines, Gelaspan can cause side effects, although not everybody experiences them. All plasma volume expanders carry a small risk of allergic reactions, which are usually mild or moderate but can in very rare cases become severe and life-threatening. These reactions are believed to be more common in patients with known allergic conditions such as asthma. For this reason, healthcare professionals monitor patients closely, particularly at the beginning of the infusion.
Very Common
May affect more than 1 in 10 patients
- Decreased red blood cell count (hemodilution effect)
- Decreased blood protein levels (dilutional hypoproteinemia)
Common
May affect up to 1 in 10 patients
- Impaired blood coagulation (dilutional coagulopathy)
- Increased bleeding tendency
Rare
May affect up to 1 in 1,000 patients
- Allergic (anaphylactic/anaphylactoid) reactions, including:
- Breathing difficulties, wheezing
- Nausea, vomiting, abdominal pain
- Dizziness, sweating
- Chest tightness, throat tightness
- Swelling of the throat and face (angioedema)
Very Rare
May affect up to 1 in 10,000 patients
- Palpitations (awareness of rapid or irregular heartbeat)
- Hypotension (low blood pressure)
- Fever, chills
Not Known
Frequency cannot be estimated from available data
- Nausea, vomiting, abdominal pain
- Decreased blood oxygen levels (may cause dizziness)
If you experience any of the following during or shortly after Gelaspan infusion, alert medical staff immediately: difficulty breathing, wheezing, swelling of the face or throat, chest tightness, sudden drop in blood pressure, severe abdominal pain, or widespread skin rash. The infusion will be stopped immediately and emergency treatment will be administered.
Side Effects in Children
There are no specific data on differences in side effects between pediatric and adult patients receiving Gelaspan. The same potential adverse effects apply. Healthcare providers exercise heightened vigilance when administering Gelaspan to children, monitoring for signs of allergic reactions, fluid overload, and hemodilution.
Reporting Side Effects
Reporting suspected adverse reactions after the medicine has been authorized is important for the ongoing monitoring of the benefit-risk balance. Healthcare professionals and patients are encouraged to report suspected side effects to their national pharmacovigilance authority (e.g., the FDA MedWatch program in the United States, the Yellow Card Scheme in the United Kingdom, or the EudraVigilance system in the European Union).
How Should Gelaspan Be Stored?
Proper storage of Gelaspan is essential to maintain the sterility and efficacy of the solution. The following storage guidelines must be observed:
- Temperature: Store at or below 25°C (77°F). Do not expose to excessive heat.
- Freezing: Do not freeze Gelaspan. Freezing may damage the container and alter the properties of the solution.
- Expiry date: Do not use after the expiration date printed on the packaging. The expiry date refers to the last day of the indicated month.
- Inspection before use: Do not use if the solution appears cloudy or discolored (it should be clear, colorless, or slightly yellowish). Do not use if the packaging shows signs of leakage or damage.
- After opening: Opened or partially used containers must be discarded. Partially used bottles or bags should not be reconnected to the infusion set.
- Keep out of reach: Store out of the sight and reach of children.
Gelaspan is available in two container types:
- LDPE bottles (Ecoflac plus): 500 mL, packaged in cartons of 10 × 500 mL
- Plastic bags (Ecobag): Non-PVC bags sealed with rubber stoppers, 500 mL, packaged in cartons of 20 × 500 mL
Not all pack sizes may be available in every market.
What Does Gelaspan Contain?
Active Substances
Each 1000 mL of Gelaspan solution contains the following active ingredients:
| Ingredient | Amount per 1000 mL |
|---|---|
| Succinylated gelatin (modified liquid gelatin) | 40.0 g |
| Sodium chloride | 5.55 g |
| Sodium acetate trihydrate | 3.27 g |
| Potassium chloride | 0.30 g |
| Calcium chloride dihydrate | 0.15 g |
| Magnesium chloride hexahydrate | 0.20 g |
Electrolyte Concentrations
| Electrolyte | Concentration (mmol/L) |
|---|---|
| Sodium (Na+) | 151 |
| Chloride (Cl−) | 103 |
| Potassium (K+) | 4 |
| Calcium (Ca2+) | 1 |
| Magnesium (Mg2+) | 1 |
| Acetate (CH3COO−) | 24 |
Other Ingredients (Excipients)
- Water for injections
- Sodium hydroxide (for pH adjustment)
- Hydrochloric acid, diluted (for pH adjustment)
Appearance
Gelaspan is a clear, colorless to slightly yellowish sterile solution for intravenous infusion. It should not be used if the solution appears cloudy, contains particles, or shows any discoloration beyond a slight yellowish tint.
Frequently Asked Questions About Gelaspan
Medical References
- European Medicines Agency (EMA). Summary of Product Characteristics: Gelaspan. B. Braun Melsungen AG. Available at: www.ema.europa.eu
- Moeller C, et al. “How safe is gelatin? A systematic review and meta-analysis of gelatin-containing plasma expanders vs crystalloids and albumin.” Journal of Critical Care. 2016;35:75–83. DOI: 10.1016/j.jcrc.2016.04.028
- Annane D, et al. “Effects of fluid resuscitation with colloids vs crystalloids on mortality in critically ill patients presenting with hypovolemic shock: the CRISTAL randomized trial.” JAMA. 2013;310(17):1809–1817. DOI: 10.1001/jama.2013.280502
- European Society of Intensive Care Medicine (ESICM). “Consensus on circulatory shock and hemodynamic monitoring.” Intensive Care Medicine. 2014;40(12):1795–1815.
- World Health Organization (WHO). WHO Model List of Essential Medicines, 23rd List (2023). Geneva: WHO; 2023.
- Commins SP, Platts-Mills TAE. “Tick bites and red meat allergy.” Current Opinion in Allergy and Clinical Immunology. 2013;13(4):354–359. DOI: 10.1097/ACI.0b013e3283624560
- Kozek-Langenecker SA, et al. “Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology (ESA).” European Journal of Anaesthesiology. 2017;34(6):332–395. DOI: 10.1097/EJA.0000000000000630
- British National Formulary (BNF). Gelatin-based plasma substitutes. Available at: bnf.nice.org.uk
About Our Medical Editorial Process
This article has been written and reviewed by our team of medical specialists with expertise in anesthesiology, critical care medicine, and clinical pharmacology. All medical information is based on peer-reviewed sources, international guidelines, and official regulatory documents.
Peer Review Process
All medical content is reviewed by at least two licensed specialist physicians before publication.
Fact-Checking
All medical claims are verified against peer-reviewed sources and international guidelines.
Update Frequency
Content is reviewed and updated at least every 12 months or when new research emerges.
Corrections Policy
Any errors are corrected immediately with a transparent changelog.
Medical Editorial Board: iMedic has an independent medical editorial board consisting of specialist physicians in anesthesiology, critical care, pharmacology, and emergency medicine.