Derleme
Yıl 2017,
Cilt: 12 Sayı: 2, 210 - 217, 30.10.2017
Öz
Bu
derlemede kolloidal solüsyonların sıvı tedavisindeki öneminin ortaya konulması
amaçlandı. Hastalıklara bağlı olarak oluşan dehidrasyon ve/veya hipovolemik şok
durumlarında hastada etkin bir sıvı tedavisi yapılmadığı takdirde oluşan şoku
takiben geri dönüşümü olmayan hücre bozuklukları, organ yetmezliği ve sonunda
ölüm meydana gelir. Bununla beraber pratikte yaygın olarak kullanılan %0.9
NaCl, Laktatlı Ringer gibi izotonik kristalloid solüsyonların ancak
1/4-1/5’inin dolaşımda kalması nedeniyle büyük hacimde verilmesi gerekmekte ve
bunun sonucu akciğer ödemi gibi önemli komplikasyonlar gelişmektedir. Buna
karşın hipovolemi ile seyreden şokların sağaltımında kullanılan kolloidal
solüsyonlar, ekstravasküler ve intrasellüler kompartmandan intravasküler bölgeye
sıvı çekerek kan volümünü kısa sürede arttırır ve etkinliğini 12-24 saat
sürdüğü bildirilmektedir. Kolloidal solüsyonların da relatif olarak pahalı
olmasının yanı sıra koagülopati, akciğer ödemi, aşırı duyarlılık reaksiyonları
ve kalsiyum konsantrasyonunda düşme gibi dezavantajları bulunmaktadır. Sonuç olarak; sıvı
tedavisinde plazma hacmini artırma amacıyla uygulanacak olan kollodial
solüsyonların etkinliği kristalloid solüsyonlardan daha fazladır. Ancak
kolloidal solüsyonların dezavantajlarını minimuma indirmek için sıvı
tedavisinde kolloidal solüsyonların kristalloid solüsyonlarla belirli oranlarda
karıştırılarak verilmesi önerilmektedir.
Anahtar Kelimeler
Kaynakça
- 1. Schaer M., 1989. General principles of fluid therapy in small animal medicine. Vet Clin North Am Small Anim Pract, 19, 203-13. 2. Yuruk K., Almac E., İnce C., 2007. Hydroxyethyl strach solution and their effect on the microcirculation and tissue oxygenation. Transfusion Alternatives in Transfusion Med, 9, 164-172. 3. Rudloff E., Kirby R., 1998. Fluid therapy. Crystalloids and colloids. Vet Clin North Am Small Anim Pract, 28, 297-328. 4. Lüke C., Widder RA., Walter P., Brunner R., Kirchhof, B., Borberg H., 2003. The effect of membrane differential filtration on the colloid osmotic pressure in patients with age-related macular degeneration: significance to visual function? Therapeutic Apheresis and Dialysis, 7, 263-268. 5. Concannon KT., Haskins SC., Feldman BF., 1992. Hemostatic defects associated with two infusion rates of dextran 70 in dogs. Am J Vet Res, 53, 1369-1375. 6. McCahon R., Hardman J., 2010. Pharmacology of plasma expanders. Anaesthesia & Intensive Care Med, 11, 75-77. 7. Hartmann H., 1995. Flüssigkeitsherapie bei Tieren. Gustav Fischer Verlag, Jena-Stuttgart. 8. Michell AR , Bywater RJ., Clarke KW., Hall WL., Waterman EA., 1989.Veterinary Fluid Therapy, Blackwell Scientific Publ, London. 9. Arnold P., Suter PF., Hagen A., 1995. Neuere Aspekte der Therapie des hypovolaemischen und septischen Schockes beim Kleintier. Kleintierpraxis, 40, 321-329. 10. Gammage G., 1987. Crystalloid versus colloid: Is colloid worth the cost? International Anesthesiology Clinics, 25, 37-60. 11. Di Bartole SP., 1992. Fluid Therapy in Small Animal Practice. W.B. Saunders Comp., Philadelphia, 12. Rackow EC., Falk JL., Fein IA., Siegel JS., Packman MI., Haupt MT., Kaufman BS., Putnam D., 1983. Fluid resuscitation in circulatory shock: a comparison of the cardiorespiratory effects of albumin, hetastarch, and saline solutions in patients with hypovolemic and septic shock. Crit Care Med, 11, 839-850. 13. Rossow N., 1995. Innere Kranheiten für Tieraerzte. Eugen Ulmer Verlag, Stuttgart. 14. Kaske M., 1994. Pathophysiologische Aspekte der neonatalen Kälberdiarrhoe. Tierärztl Umschau, 49, 336-348. 15. Walker PG., Constable PD., Morin DE., Foreman JH., Drackley JK., Thurmon JC., 1998. Comparison of hypertonic saline-dextran solution and lactated Ringer's solution for resuscitating severely dehydrated calves with diarrhea. JAVMA, 213, 113-121.
- 16. Fayet JC., 1971. Plasma and faecal osmolality, water kinetics and body fluid compartments in neonatal calves with diarrhoea. Br Vet J, 127, 37. 17. Phillips RW., Lewis LD., 1973. Viral induced changes in intestinal transport and resultant body fluid alterations in neonatal calves. Ann Rech Vet, 4, 87-98. 18. Argenzio RA., 1984.Pathophysiology of neonatal diarrhea. Agri-Practic,. 5, 25-32. 19. Klee W., 1989. Aspekte der Behandlung neugeborener Kaelber mit akutem Durchfall. Vet, 5, 6-17. 20. Constable PD., Gohar HM., Morin DE., Thurmon JC., 1996. Use of hypertonic saline-dextran solution to resuscitate hypovolemic calves with diarrhea. American Journal of Veterinary Research, 57, 97-104. 21. Kutas F.,1988. Störungen des Wasser-und Elektrolythaushaltes. In” Innere Krankheiten der Haustiere. Bd ll: Funktionelle Störungen”. Hrsg. Rossow, N., Horvath, Z., 478-493, G. Fischer Verlag, Jena, 22. Pospischil A., 1989. Pathologie und Pathogenese infektiöser Durchfallerkrankungen beim Kalb. Vet, 5, 27-32. 23. Baljer G, Wieler L., 1989. Ätiologie, Pathogenese und Immunprophylaxe der neonatalen Durchfallerkrankungen der Kälber. Vet, 5, 18-26. 24. Hall GA., Jones PW., Morgan JH., 1996. Calf diarrhoea. In” Bovine Medicine. Diseases and Husbuandry of Cattle”, Ed. Andrews, A. H., 154-180, Blackwell, Berlin. 25. Şahal M., Ünsüren H., İmren HY., 1993. Untersuchungen zur lnfusionstherapie bei neugeborenen durchfaelligen Kaelbern aus der Umgebung von Ankara unter spezieller Berücksichtigung einer Azidose (l. Mitteilung). Dtsch tieraerztl Wschr, 100, 138-142. 26. Şahal M., Kurtdede A., Börkü MK., Ünsüren H., İmren HY., Özlem MB., Kalınbacak, A., 1994. Yenidoğan ishalli buzağıların klinik bulguları ve asit-baz dengesi dikkate alınarak sodyum bikarbonat ve elektrolitik sıvılarla sağaltımı. Ankara Üniv Vet Fak Derg, 41, 509-525. 27. Hapke HJ., 1983. Arzneimitteltherapie. F. Enke Verlag, Stuttgart. 28. Mazzaferro EM., Rudloff E., Kirby R., 2002. The role of albumin replacement in the critically ill veterinary patient. J Vet Emerg Crit Care, 12, 113-124. 29. Clark MA., 1993. Bovine coronavirus and neonatal calf diarrhoea. Br Vet J, 149, 51-70. 30. Göbel E., 1990. Die Kryptosporidiose des neugeborenen Kalbes: Erreger, Krankheitsgeschehen und Bekaemfung. Prakt Tieraerzt Col Vet, 72, 14-16. 31. 31. Finfer S., Bellomo R., Boyce N., French J., Myburgh J., Norton R., 2004. A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med, 350, 2247-56. 32. Kozat S., 2000. İshalli Buzağılarda Kristalloid (Laktatli Ringer) Ve Kolloid + Kristalloid (% 6 dekstran-70+laktatlı ringer) infüzyon solüsyonlarının rehidratasyon etkinliği. Doktora Tezi, YYÜ Sağ Bil Enst, Türkiye. 33. Löwe G., 1988. Internistische Intensivmedizin. In” Innere Krankheiten der Haustiere. Bd ll: Funktionelle Störungen” Hrsg. Rossow, N., Horvath, Z., 721-758, G. Fischer Verlag, Jena. 34. 34. Hartmann H., Reder S., 1995. Einfluss von Dehydratationen auf funktionelle Parameter des Flussigkeitshaushaltes sowie Wirksamkeit einer Rehydratation mit kristalliner oder kalloidaler Infusionslösung bei Kälbern. Tieräztl Prax, 23, 342-450. 35. Okrasinskki EB., Krahwinkel DJ., Sanders WL., 1992. Treatment of dogs in hemorrhagic shock by intraosseous infusion of hypertonic saline and dextran. Vet Surg, 21, 20-24. 36. Blauhut BB., Lundsgoard –Hansen P., 1986. Albumin and the systemic circulation. Ann Surg, 18, 186-198. 37. Constable PD., Schmall LM., Muir WW., Hoffsis GF., Shertel, ER., 1991. Hemodynamic response of endotoxemic calves to treatment with small-volume hypertonic saline solution. Am J Vet Res, 52, 981-989. 38. Corke MJ., 1988. Economical preparation of fluids for intravenous use in cattle practice. The Vet Rec, 122, 305-307. 39. Isbister JP., Fisher, MM., 1980. Adverse effects of plasma volume expanders. Anaesthesia and Intensive Care, 8, 145-151. 40. Berliner AD., Lackner H., 1972. Hemorrhagic diathesis after prolonged infusion of low molecular weight dextran. Am J Med Sci, 263, 397-404.
Yıl 2017,
Cilt: 12 Sayı: 2, 210 - 217, 30.10.2017
Öz
This issue was aimed to display
importance of colloidal solutions for fluid treatment. Occurring dehydration or
hypovolemia
shock states due to diseases, which was not applied effective therapy fluid,
this situation will be followed by shock, irreversible cell damage, organ
failure and finally, death. However, isotonic crystalloid solutions such as
0.9% NaCl and Lactated Ringer, which are commonly used in practice, are
required to be given in large volumes due to circulation of 1 / 4-1 / 5, and this
leads to significant complications such as pulmonary edema. On the other hand,
colloidal solutions used for the treatment of shocks with hypovolemia increase
the volume of blood rapidly by pulling fluid to the intravascular region from
the extravasculer and intracellular compartment and its effectiveness is
reported to last 12-24 hours. But colloidal solutions, which are disadvantages
such as, pulmonary edema, excessive sensibility reactions decreased calcium
concentrations are also excessive expensive. In conclusion, administration of colloidal solution
for fluid treatment induced greater and more persistent increase in plasma
volume than of those of crystalloid. However, in order to minimize the
disadvantages of colloidal solutions, it is recommended that colloidal
solutions be mixed with crystalloid solutions at certain ratios in fluid
treatment.
Anahtar Kelimeler
Kaynakça
- 1. Schaer M., 1989. General principles of fluid therapy in small animal medicine. Vet Clin North Am Small Anim Pract, 19, 203-13. 2. Yuruk K., Almac E., İnce C., 2007. Hydroxyethyl strach solution and their effect on the microcirculation and tissue oxygenation. Transfusion Alternatives in Transfusion Med, 9, 164-172. 3. Rudloff E., Kirby R., 1998. Fluid therapy. Crystalloids and colloids. Vet Clin North Am Small Anim Pract, 28, 297-328. 4. Lüke C., Widder RA., Walter P., Brunner R., Kirchhof, B., Borberg H., 2003. The effect of membrane differential filtration on the colloid osmotic pressure in patients with age-related macular degeneration: significance to visual function? Therapeutic Apheresis and Dialysis, 7, 263-268. 5. Concannon KT., Haskins SC., Feldman BF., 1992. Hemostatic defects associated with two infusion rates of dextran 70 in dogs. Am J Vet Res, 53, 1369-1375. 6. McCahon R., Hardman J., 2010. Pharmacology of plasma expanders. Anaesthesia & Intensive Care Med, 11, 75-77. 7. Hartmann H., 1995. Flüssigkeitsherapie bei Tieren. Gustav Fischer Verlag, Jena-Stuttgart. 8. Michell AR , Bywater RJ., Clarke KW., Hall WL., Waterman EA., 1989.Veterinary Fluid Therapy, Blackwell Scientific Publ, London. 9. Arnold P., Suter PF., Hagen A., 1995. Neuere Aspekte der Therapie des hypovolaemischen und septischen Schockes beim Kleintier. Kleintierpraxis, 40, 321-329. 10. Gammage G., 1987. Crystalloid versus colloid: Is colloid worth the cost? International Anesthesiology Clinics, 25, 37-60. 11. Di Bartole SP., 1992. Fluid Therapy in Small Animal Practice. W.B. Saunders Comp., Philadelphia, 12. Rackow EC., Falk JL., Fein IA., Siegel JS., Packman MI., Haupt MT., Kaufman BS., Putnam D., 1983. Fluid resuscitation in circulatory shock: a comparison of the cardiorespiratory effects of albumin, hetastarch, and saline solutions in patients with hypovolemic and septic shock. Crit Care Med, 11, 839-850. 13. Rossow N., 1995. Innere Kranheiten für Tieraerzte. Eugen Ulmer Verlag, Stuttgart. 14. Kaske M., 1994. Pathophysiologische Aspekte der neonatalen Kälberdiarrhoe. Tierärztl Umschau, 49, 336-348. 15. Walker PG., Constable PD., Morin DE., Foreman JH., Drackley JK., Thurmon JC., 1998. Comparison of hypertonic saline-dextran solution and lactated Ringer's solution for resuscitating severely dehydrated calves with diarrhea. JAVMA, 213, 113-121.
- 16. Fayet JC., 1971. Plasma and faecal osmolality, water kinetics and body fluid compartments in neonatal calves with diarrhoea. Br Vet J, 127, 37. 17. Phillips RW., Lewis LD., 1973. Viral induced changes in intestinal transport and resultant body fluid alterations in neonatal calves. Ann Rech Vet, 4, 87-98. 18. Argenzio RA., 1984.Pathophysiology of neonatal diarrhea. Agri-Practic,. 5, 25-32. 19. Klee W., 1989. Aspekte der Behandlung neugeborener Kaelber mit akutem Durchfall. Vet, 5, 6-17. 20. Constable PD., Gohar HM., Morin DE., Thurmon JC., 1996. Use of hypertonic saline-dextran solution to resuscitate hypovolemic calves with diarrhea. American Journal of Veterinary Research, 57, 97-104. 21. Kutas F.,1988. Störungen des Wasser-und Elektrolythaushaltes. In” Innere Krankheiten der Haustiere. Bd ll: Funktionelle Störungen”. Hrsg. Rossow, N., Horvath, Z., 478-493, G. Fischer Verlag, Jena, 22. Pospischil A., 1989. Pathologie und Pathogenese infektiöser Durchfallerkrankungen beim Kalb. Vet, 5, 27-32. 23. Baljer G, Wieler L., 1989. Ätiologie, Pathogenese und Immunprophylaxe der neonatalen Durchfallerkrankungen der Kälber. Vet, 5, 18-26. 24. Hall GA., Jones PW., Morgan JH., 1996. Calf diarrhoea. In” Bovine Medicine. Diseases and Husbuandry of Cattle”, Ed. Andrews, A. H., 154-180, Blackwell, Berlin. 25. Şahal M., Ünsüren H., İmren HY., 1993. Untersuchungen zur lnfusionstherapie bei neugeborenen durchfaelligen Kaelbern aus der Umgebung von Ankara unter spezieller Berücksichtigung einer Azidose (l. Mitteilung). Dtsch tieraerztl Wschr, 100, 138-142. 26. Şahal M., Kurtdede A., Börkü MK., Ünsüren H., İmren HY., Özlem MB., Kalınbacak, A., 1994. Yenidoğan ishalli buzağıların klinik bulguları ve asit-baz dengesi dikkate alınarak sodyum bikarbonat ve elektrolitik sıvılarla sağaltımı. Ankara Üniv Vet Fak Derg, 41, 509-525. 27. Hapke HJ., 1983. Arzneimitteltherapie. F. Enke Verlag, Stuttgart. 28. Mazzaferro EM., Rudloff E., Kirby R., 2002. The role of albumin replacement in the critically ill veterinary patient. J Vet Emerg Crit Care, 12, 113-124. 29. Clark MA., 1993. Bovine coronavirus and neonatal calf diarrhoea. Br Vet J, 149, 51-70. 30. Göbel E., 1990. Die Kryptosporidiose des neugeborenen Kalbes: Erreger, Krankheitsgeschehen und Bekaemfung. Prakt Tieraerzt Col Vet, 72, 14-16. 31. 31. Finfer S., Bellomo R., Boyce N., French J., Myburgh J., Norton R., 2004. A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med, 350, 2247-56. 32. Kozat S., 2000. İshalli Buzağılarda Kristalloid (Laktatli Ringer) Ve Kolloid + Kristalloid (% 6 dekstran-70+laktatlı ringer) infüzyon solüsyonlarının rehidratasyon etkinliği. Doktora Tezi, YYÜ Sağ Bil Enst, Türkiye. 33. Löwe G., 1988. Internistische Intensivmedizin. In” Innere Krankheiten der Haustiere. Bd ll: Funktionelle Störungen” Hrsg. Rossow, N., Horvath, Z., 721-758, G. Fischer Verlag, Jena. 34. 34. Hartmann H., Reder S., 1995. Einfluss von Dehydratationen auf funktionelle Parameter des Flussigkeitshaushaltes sowie Wirksamkeit einer Rehydratation mit kristalliner oder kalloidaler Infusionslösung bei Kälbern. Tieräztl Prax, 23, 342-450. 35. Okrasinskki EB., Krahwinkel DJ., Sanders WL., 1992. Treatment of dogs in hemorrhagic shock by intraosseous infusion of hypertonic saline and dextran. Vet Surg, 21, 20-24. 36. Blauhut BB., Lundsgoard –Hansen P., 1986. Albumin and the systemic circulation. Ann Surg, 18, 186-198. 37. Constable PD., Schmall LM., Muir WW., Hoffsis GF., Shertel, ER., 1991. Hemodynamic response of endotoxemic calves to treatment with small-volume hypertonic saline solution. Am J Vet Res, 52, 981-989. 38. Corke MJ., 1988. Economical preparation of fluids for intravenous use in cattle practice. The Vet Rec, 122, 305-307. 39. Isbister JP., Fisher, MM., 1980. Adverse effects of plasma volume expanders. Anaesthesia and Intensive Care, 8, 145-151. 40. Berliner AD., Lackner H., 1972. Hemorrhagic diathesis after prolonged infusion of low molecular weight dextran. Am J Med Sci, 263, 397-404.
Toplam 2 adet kaynakça vardır.
Ayrıntılar
| Bölüm | Derlemeler |
|---|---|
| Yazarlar | |
| Yayımlanma Tarihi | 30 Ekim 2017 |
| Yayımlandığı Sayı | Yıl 2017 Cilt: 12 Sayı: 2 |