[The role of infusion fluids and blood derived preparations during the perioperative period]

The treatment with infusion fluids in perioperative period is a basic therapeutic method. Depending on clinical situation, the doctor has various fluids available, both blood-replacing, and blood-derived. The number of crystaloid and colloidal fluids used has been systematically growing in two last decades. Ever more importance, beside the 0.9% NaCl solution and Ringer's solution used, is gaining 7.5% NaCl solution and hydroxyethyl starch solutions. The production of hydroxyethyl starch solutions in Poland has created an alternative to the use of dextran and gelatin solutions. The change towards treatment with blood components has caused the change of the strategy of therapeutic management of patients used as yet. For compensation of oxygen demand during blood loss, erythrocyte concentrate is commonly used. Such management requires blood-clotting factor monitoring. Hypofibrinogenaemia develops earlier than deficiencies of the remaining blood-clotting factors and later than thrombocytopenia. The use of fresh frozen plasma (FFP) is the first step in the treatment of pathological bleeding in surgically treated patients. The occurrence of thrombocytopenia shows great individual variability. Thrombocyte concentrate transfusion should be performed after laboratory determination of thrombocyte count.