Perioperatives Flüssigkeitsmanagement – Welches Volumen für welchen Patienten?

Zusammenfassung

Die Diskussion über den Stellenwert kristalliner, synthetischer und natürlicher kolloidaler Volumenersatzmittel ist neu entbrannt. Im Hinblick auf den Endpunkt Letalität finden sich bislang keine definitiven Vorteile für die eine oder andere Substanzgruppe. Die Datenlage bezüglich unerwünschter Organeffekte der einzelnen Volumenersatzmittel erlaubt allerdings durchaus eine Definition von Subgruppen, welche präferenziell eher mit kristallinen oder spezifischen kolloidalen Substanzen behandelt werden sollten.

Abstract

There is a renewed discussion about the role of crystalloids and natural as well as synthetic colloids in fluid resuscitation. Based on the currently available evidence the choice of fluid replacement does not influence mortality. However, there is increasing evidence that due to unwarranted organ effects of the specific replacement fluids, individual subgroups of patients may be preferentially treated either with cristalloids or colloids.

Schlüsselwörter:

Volumentherapie - Volumenersatzmittel - kristallin - kolloidal - Hydroxethylstärke - Gelatine - Humanalbumin - akutes Nierenversagen.

Key words:

fluid therapy - fluid replacement - crystalloid - colloid - hydroxethylstarch - gelatine - human albumin - acute kidney injury

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