Sıvı Tedavisinde Kolloidal Solüsyonların Önemi

Yıl 2017, Cilt: 12 Sayı: 2, 210 - 217, 30.10.2017

Süleyman Kozat

https://doi.org/10.17094/ataunivbd.347979

Öz

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

Öz

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.

Anahtar Kelimeler

Colloidal solutions, Fluid Therapy

Kaynakça

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