6533b872fe1ef96bd12d4093

RESEARCH PRODUCT

Forderungen und Erwartungen an einen optimalen Volumenersatz

H. A. AdamsMeier-hellmann ABoldt JThomas StandlHiesmayr MjSpahn DrR. Zander

subject

medicine.medical_specialtyBicarbonateVolume replacementActive componentsBlood volumeGeneral MedicineElectrolyteCritical Care and Intensive Care MedicineSurgerychemistry.chemical_compoundAnesthesiology and Pain MedicinechemistryHypovolemiaEmergency MedicinemedicineIntravascular volume statusmedicine.symptomIntensive care medicine

description

A volume replacement should compensate a reduction in the intravascular volume and counteract a hypovolemia so that hemodynamics and vital functions can be maintained. For this therapy, a physiologically-based solution comprising both osmotically and colloid osmotically active components should be administered. A consensus is proposed for this purpose which takes into consideration the following aspects: The optimum colloid, the questionable use of albumin, the physiological electrolyte pattern encompassing sodium, potassium, chloride and phosphate and their contributions to osmolality, an eventual addition of glucose, the physiological acid-base status with bicarbonate or alternately with metabolisable anions, and the importance of a clear declaration of all ingredients. The consensus distinguishes between compulsory requirements derived from evidence-based medicine and physiological data and the potential expectations of an optimal volume replacement, including well-grounded wishes and aspirations for the future.

https://doi.org/10.1055/s-2005-870452