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Fluid Replacement in Treatment of Hypovolemia and Shock: Crystalloids and Colloids

Yıl 2013, Cilt: 22 Sayı: 3, 347 - 361, 01.09.2013

Öz

Shock is a pathologic state with high mortality rate and characterized by a reduction of systemic tissue perfusion and decresead oxygen delivery. Absolute or relative hypovolemia is a common pathology of most shock types. Correction of hypovolemia might reverse the disturbance and increase the tissue perfusion. Fluid resuscitation with crystalloid and colloid solutions can carry the risk of increasing morbidity and mortality if not used properly. Although crystalloid and colloid solutions are considered to have equal efficacy and safety profile, recent studies showed that this assumption may not be correct. Early and effective management of hypovolemia is the cornerstone of shock resuscitation. Initial management of patients with septic shock and hypovolemia should be done with 30ml/kg of crystalloids. Proper fluid replacement and resuscitation algoritms might increase the sürvival rate.

Kaynakça

  • Tümay V, Toktay R. Hipovolemik şok. Yoğun Bakım Dergisi. 2002; 2:246-54
  • Sheldon GF, Watkins GM, Glover JL, Greenburg AG, Friedman BA. Panel: "present use of blood and blood products". J Trauma. 1981; 21:1005-12.
  • Bellomo R, Morimatsu H, French C, Cole L, Story D, Uchino S, et al. SAFE Study Investigators. The effects of saline or albumin resuscitation on acid-base status and serum electrolytes. Crit Care Med. 2006; 34:2891-7.
  • Upadhyay M, Singhi S, Murlidharan J, Kaur N, Majumdar S. Randomized evaluation of fluid resuscitation with crystalloid (saline) and colloid (polymer from degraded gelatin in saline) in pediatric septic shock. Indian Pediatr. 2005; 42:223-31.
  • Matheson NA, Diomi P. Renal failure after the administration of dextran 40. Surg Gynecol Obstet. 1970; 131;661-8.
  • Denis R, Smith RW, Grabow D, Ledgerwood AM, Lucas CE. Relocation of nonalbumin proteins after albumin resuscitation. J Surg Res 1987; 43:413-9.
  • Leibold WC, Lucas CE, Ledgerwood AM, Mammen EF, Denis R, Grabow D et al. Effect of albumin resuscitation on canine coagulation activity and content. Ann Surg. 1983; 198:630-3. Virgilio RW, Rice CL, Smith DE, James DR, Zarins CK, Hobelmann CF et al. Crystalloid vs. colloid resuscitation: is one better? A randomized clinical study. Surgery. 1979; 85:129-39. Swisher SN. Overview of fresh frozen plasma. In Fresh Frozen Plasma: Indications and Risk. Bethesda, MD: NIH Consensus Development Conference,1984;13-18.
  • Martin DJ, Lucas CE, Ledgerwood AM, Hoschner J, McGonigal MD, Grabow D. Fresh frozen plasma supplement to massive red blood cell transfusion. Ann Surg. 1985; 202:505-10.
  • Lucas CE, Ledgerwood AM. Fresh frozen plasma/red blood cell resuscitation regimen that restores procoagulants without causing adult respiratory distress syndrome. J Trauma Acute Care Surg. 2012; 72:821-7.
  • Petroianu GA, Maleck WH, Koetter KP, Liu J, Schmitt A. Effect of in vitro hemodilution with hydroxyethyl starch and dextran on the activity of plasma clotting factors. Crit Care Med. 2003; 31:250-4.
  • Zdolsek HJ, Vegfors M, Lindahl TL, Törnquist T, Bortnik P, Hahn RG. Hydroxyethyl starches and dextran during hip replacement surgery: effects on blood volume and coagulation. Acta Anaesthesiol Scand. 2011; 55:677-85.
  • Treib J, Haass A, Pindur G, Seyfert UT, Treib W, Grauer MT et al. HES 200/0.5 is not HES 200/0.5. Influence of the C2/C6 hydroxyethylation ratio of hydroxyethyl starch (HES) on hemorheology, coagulation and elimination kinetics. Thromb Haemost. 1995; 74:1452-6.

Hipovolemi ve Şok Tedavisinde Sıvı Seçimi: Kristalloid ve Kolloidler

Yıl 2013, Cilt: 22 Sayı: 3, 347 - 361, 01.09.2013

Öz

Şok yüksek mortalite ile seyreden erken ve hızlı müdahale gerektiren bir patolojidir. Dolaşım sisteminin dokuların metabolik substrat ihtiyacını karşılamaması olarak tanımlanabilecek şok tiplerinin bir çoğunda ortak nokta mutlak veya relatif hipovolemidir. Hipovoleminin düzeltilmesi için sıkça kullanılan kristalloid ve kolloid solusyonlar, uygun kullanılmadıkları zaman morbiditeyi ve mortaliteyi artırma riski taşıyabilmektedirler. Yakın zamanlara kadar uzlaşı rehberlerinde kristalloid ve kolloid solusyonlar eşit etkinlik ve güvenlik profiline sahip olarak belirtilmesine rağmen, yeni çalışmalar bu varsayımın doğru olmayabileceğini göstermiştir. Hipovolemi'de sıvı replasmanının hızlı ve etkin yapılması en uygun tedavi yaklaşımıdır. Septik şok ve hipovolemisi olan hastaların başlangıç sıvı yönetimi 30ml/kg kristalloid ile yapılmalıdır. Uygun sıvı seçimi ve resüsitasyon algoritmaları hastaların sağ kalım şansını artırabilmektedir.

Kaynakça

  • Tümay V, Toktay R. Hipovolemik şok. Yoğun Bakım Dergisi. 2002; 2:246-54
  • Sheldon GF, Watkins GM, Glover JL, Greenburg AG, Friedman BA. Panel: "present use of blood and blood products". J Trauma. 1981; 21:1005-12.
  • Bellomo R, Morimatsu H, French C, Cole L, Story D, Uchino S, et al. SAFE Study Investigators. The effects of saline or albumin resuscitation on acid-base status and serum electrolytes. Crit Care Med. 2006; 34:2891-7.
  • Upadhyay M, Singhi S, Murlidharan J, Kaur N, Majumdar S. Randomized evaluation of fluid resuscitation with crystalloid (saline) and colloid (polymer from degraded gelatin in saline) in pediatric septic shock. Indian Pediatr. 2005; 42:223-31.
  • Matheson NA, Diomi P. Renal failure after the administration of dextran 40. Surg Gynecol Obstet. 1970; 131;661-8.
  • Denis R, Smith RW, Grabow D, Ledgerwood AM, Lucas CE. Relocation of nonalbumin proteins after albumin resuscitation. J Surg Res 1987; 43:413-9.
  • Leibold WC, Lucas CE, Ledgerwood AM, Mammen EF, Denis R, Grabow D et al. Effect of albumin resuscitation on canine coagulation activity and content. Ann Surg. 1983; 198:630-3. Virgilio RW, Rice CL, Smith DE, James DR, Zarins CK, Hobelmann CF et al. Crystalloid vs. colloid resuscitation: is one better? A randomized clinical study. Surgery. 1979; 85:129-39. Swisher SN. Overview of fresh frozen plasma. In Fresh Frozen Plasma: Indications and Risk. Bethesda, MD: NIH Consensus Development Conference,1984;13-18.
  • Martin DJ, Lucas CE, Ledgerwood AM, Hoschner J, McGonigal MD, Grabow D. Fresh frozen plasma supplement to massive red blood cell transfusion. Ann Surg. 1985; 202:505-10.
  • Lucas CE, Ledgerwood AM. Fresh frozen plasma/red blood cell resuscitation regimen that restores procoagulants without causing adult respiratory distress syndrome. J Trauma Acute Care Surg. 2012; 72:821-7.
  • Petroianu GA, Maleck WH, Koetter KP, Liu J, Schmitt A. Effect of in vitro hemodilution with hydroxyethyl starch and dextran on the activity of plasma clotting factors. Crit Care Med. 2003; 31:250-4.
  • Zdolsek HJ, Vegfors M, Lindahl TL, Törnquist T, Bortnik P, Hahn RG. Hydroxyethyl starches and dextran during hip replacement surgery: effects on blood volume and coagulation. Acta Anaesthesiol Scand. 2011; 55:677-85.
  • Treib J, Haass A, Pindur G, Seyfert UT, Treib W, Grauer MT et al. HES 200/0.5 is not HES 200/0.5. Influence of the C2/C6 hydroxyethylation ratio of hydroxyethyl starch (HES) on hemorheology, coagulation and elimination kinetics. Thromb Haemost. 1995; 74:1452-6.
Toplam 12 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Derleme
Yazarlar

Fatih Yıldız

Emre Karakoç Bu kişi benim

Yayımlanma Tarihi 1 Eylül 2013
Yayımlandığı Sayı Yıl 2013 Cilt: 22 Sayı: 3

Kaynak Göster

AMA Yıldız F, Karakoç E. Hipovolemi ve Şok Tedavisinde Sıvı Seçimi: Kristalloid ve Kolloidler. aktd. Eylül 2013;22(3):347-361.