Hypovolämie: Teil 2: Flüssigkeits- und Volumentherapie, spezielle Aspekte

Abstract

Hypovolaemic shock is caused by a critically reduced cardiac preload derived from volume deficiency. In the prehospital setting little can be done to quantify the severity of the hypovolaemia. However, to prevent an imminent shock, respectively keeping it compensated, is of vital importance. There is a lot of discussion regarding fluid replacement especially in the anaesthesiologic section. Balanced electrolyte solutions avoid side effects such as dilution-acidosis and disturbance of renal function caused by classical solutions (saline-solution, Ringer's lactate). The same applies to colloid solutions. Latest preparations of hydroxyethylstarch have less side effects on coagulation and renal function than those with a greater molecular weight. Pediatric solutions are likely to cause serious complications such as brain edema and hyperglycaemia. This article focuses on fluid replacement and appropriate solutions in hypovolaemic shock. Special conditions which may lead to hypovolaemic shock are discussed. Pediatric distinctions will be mentioned particularly. © Georg Thieme Verlag KG Stuttgart.