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Dextran 40 is a sterile, nonpyrogenic solution of low molecular weight dextran, averaging 40,000 daltons, dissolved in either 5% dextrose or 0.9% sodium chloride for intravenous infusion. Produced by fermenting sucrose with the bacterium *Leuconostoc mesenteroides* (strain B-512), dextran 40 is composed of glucose units linked predominantly by α-1,6 glucosidic bonds. In medical settings, it functions as a plasma volume expander, enhancing blood flow, particularly in the microcirculation, by increasing blood volume and reducing viscosity. This property makes it useful in treating hypovolemia resulting from trauma, burns, or surgery. Additionally, dextran 40 exhibits antithrombotic effects by decreasing platelet aggregation and adhesiveness, which can help prevent postoperative venous thrombosis. However, its use has declined in favor of safer and more effective alternatives like crystalloids and albumin. Potential side effects include allergic reactions ranging from mild urticaria to severe anaphylactoid responses, as well as risks of circulatory overload, particularly in patients with compromised renal function. Therefore, careful patient evaluation and monitoring are essential when administering dextran 40.