Zusammenfassung
Ungeachtet der Verwendung von Kolloiden haben Kristalloide in der heutigen Intensivmedizin einen festen Stellenwert: Neben der Substitution als Basisbedarf des Organismus oder Medikamententräger werden sie primär zum Volumenersatz verwendet. Eine häufige Komplikation ist die Entwicklung von interstitiellen Ödemen, was in der Zusammensetzung dieser Lösungen und der Permeabilität der Glykokalyx liegt.
Bei der Vielzahl auf dem Markt befindlicher Varianten haben sich mittlerweile die auf Bikarbonatvorläufer basierenden isotonen balancierten Vollelektrolytlösungen herauskristallisiert. Die Verwendung von 0,9 %iger Kochsalzlösung ist inzwischen als obsolet anzusehen.
Bei niedrigen Anschaffungskosten und gutem Sicherheitsprofil sind in der Anwendung von Kristalloiden wenige relevante Dinge, wie die Gefahr der Hypervolämie und Dysbalance des Elektrolythaushalts, zu beachten.
Abstract
Notwithstanding the use of colloids, crystalloids have a firm position in todayʼs intensive care: In addition to the substitution as a basic requirement of the human organism or drug carriers, they are primarily used for volume replacement. A common complication is the development of interstitial edema, which is due to the composition of these solutions and the permeability of the glycocalyx.
With the large variety available on the market, bicarbonate-based precursor isotonic-balanced full electrolyte solutions have become established in the meantime. The use of 0.9 % saline solution is regarded as obsolete.
With low cost and a good safety profile, a few relevant aspects, e.g., the risk of hypervolemia and electrolyte imbalance, must be taken into account in the use of crystalloids.
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R. Wildenauer gibt an, Vortragshonorare und Reisekostenerstattungen von CSL Behring GmbH erhalten zu haben und Inhaber von Aktien der Fresenius SE & Co. KGaA zu sein.
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Wildenauer, R. Dos and Don’ts für Kristalloide in der Intensivmedizin. Med Klin Intensivmed Notfmed 110, 127–132 (2015). https://doi.org/10.1007/s00063-015-0007-1
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DOI: https://doi.org/10.1007/s00063-015-0007-1