Zusammenfassung
Bevor eine Infusionstherapie initiiert wird, ist zu unterscheiden, was therapiert
werden soll: ein intravasaler Volumenmangel oder ein Flüssigkeitsmangel des gesamten
Extrazellulärraumes. Danach richten sich die therapeutische Strategie der Flüssigkeits-
und Volumentherapie sowie die Auswahl der zu verabreichenden Infusionslösungen, die
dieser Beitrag vorstellt.
Abstract
A rational infusion therapy orchestrates fluid- and volume therapy based on the individual
indication and situation. The principle of fluid replacement is to substitute ongoing
fluid losses such as insensible perspiration and urine output or to treat dehydration
with balanced crystalloid solutions. Volume therapy in contrast is the quick restoration
of intravascular losses such as an acute blood loss through application of balanced
colloids or crystalloids. The goal of volume therapy is to maintain normal cardiac
output and oxygen delivery by restoring intravascular normovolemia and cardiac preload.
Whether colloid or crystalloid infusions are most suitable for volume therapy remains
unclear. Most trials in this field are either underpowered or used colloids in inadequate
situations, patients and amounts. Two major trials from the European Society of Anaesthesiology
and Intensive Care (ESAIC) are underway that seem promising to provide evidence in
this emotional
debate.
Schlüsselwörter
Flüssigkeitstherapie - Volumentherapie - Kristalloide - Kolloide - Hydroxyethlystärke
Key words
fluid therapy - volume therapy - crystalloids - colloids - hydroxyethyl starch
