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Volume therapy or infusion therapy is used worldwide for the
treatment of hypovolemia caused by surgical blood and plasma
losses, trauma, burns, or infections. Interestingly, significant
differences exist between countries regarding the use of plasma
substitutes. In the United States, crystalloids and albumin are
more popular, whereas in Europe artificial colloids such as
hydroxyethyl starch are preferred. From an international
perspective, it is notable that volume therapy using hydroxyethyl
starch is an established therapy for the treatment of cerebral,
retinal, otogenic, and peripheral circulation disorders in Germany.
In other countries, crys talloids are mostly used to treat
dehydration or hypovolemia, for example in brain stroke. In recent
years, new data made it possible to overcome national differences
and agree on an evidence-based, international con sensus. The
efficacy of different plasma substitutes for a volume therapy last
ing several days has not been sufficiently studied in the past.
Long-term volume therapy of patients with cerebral perfusion
disorders is an excel lent model for studying the effects of
artificial colloids in detail, because of the high doses of
colloids that are administered. Through a compari son of commonly
used plasma substitutes, we were able to show that sig nificant
differences exist between different colloids, for example in their
effect on coagulation. After repeated infusion, hydroxyethyl
starches that are difficult to degrade lead to an accumulation of
large molecules that are difficult to eliminate. These large
molecules impair factor VIII/von Willebrand factor."
Das Buch enth{lt eine aktuelle Bestandsaufnahme }ber die
pathologischen Grundlagen des akuten Nierenversagens (ANV), die
Prinzipien und Techniken der maschinellen Blutreinigungsverfahren
(H{mofiltration, H{modialyse) sowie deren
klinisch-intensivmedizinische Einsatzm|glichkeiten. Als
zus{tzliches Thema wird die H{mapherese (Plasmaaustausch,
Plasmasorption, Plasmapherese) abgehandelt. Die Beitr{ge der
interdisziplin{ren Autorengruppe - An{sthesiologen,
Intensivmediziner, Internisten, Nephrologen, Transfusionsmediziner
- werden abgerundet und vertieft durch eine am Schlu~ des Buches
zusammengefa~te Diskussion.
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