Sıvı Tedavisinde Kolloidal Solüsyonların Önemi

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:

Kolloidal solüsyonlar, Sıvı tedavisi

Importance of Colloidal Solutions in Fluid Treatment

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.

Keywords:

Colloidal solutions, Fluid Therapy,

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