Rationale Flüssigkeits- und Volumentherapie – eine kritische Betrachtung unter Berücksichtigung aktueller Empfehlungen und Leitlinien

Zusammenfassung

Trotz aktueller Leitlinienempfehlungen kann die Diskussion über den Stellenwert kristalliner, synthetischer und natürlicher kolloidaler Infusionslösungen im Rahmen perioperativer und intensivmedizinischer Therapie keineswegs als abgeschlossen betrachtet werden.

So fehlen nicht nur klare Daten zur Sicherheit einer rein kristallinen Volumentherapie und zum Einsatz künstlicher Kolloide bei operativen Risikopatienten, es stellt sich ebenfalls zunehmend die Frage, ob kritisch kranke Intensivpatienten und insbesondere Patienten im septischen Schock – entgegen gegenwärtigen Empfehlungen – nicht doch von einer mit Humanalbumin ergänzten Volumentherapie profitieren.

Zielsetzung der vorliegenden Arbeit ist es, das Für und Wider beim Einsatz der verschiedenen Infusionslösungen zur Volumentherapie unter Berücksichtigung physiologischer und pathophysiologischer Aspekte und vor dem Hintergrund aktueller Studien und Empfehlungen kritisch zu beleuchten.

Schlüsselwörter

Volumentherapie - Volumenersatzmittel - kristallin - kolloidal - Hydroxyethylstärke - Gelatine - Humanalbumin - akutes Nierenversagen

• Literatur

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