[Use of colloids in acute hypovolemia]

Area of Science:

• Pharmacology
• Critical Care Medicine
• Biochemistry

Context:

• Overview of available plasma expanders in Denmark.
• Comparison of natural (fresh frozen plasma, human albumin) and synthetic colloids.
• Discussion of limitations including infectious risks (FFP), cost (HA), and side effects (HC).

Purpose:

• To compare the efficacy and side effect profiles of various natural and synthetic colloids used as plasma expanders.
• To evaluate the utility of different colloids in managing hypovolemia and compromised regional blood flow.
• To assess the potential of Haes-steril (HS) and Macrodex (MD) as alternatives to human albumin (HA).

Summary:

• Synthetic colloids like Haes-steril (HS) and Macrodex (MD) are effective volume substitutes, offering benefits such as inhibiting erythrocyte aggregation and leucocyte marginalisation.
• Haes-steril (HS) 10% and human albumin (HA) 20% are hyperoncotic, aiding fluid redistribution. Macrodex (MD) exhibits an anti-thrombotic effect but can increase bleeding time.
• Both HS and MD restore colloid osmotic pressure and can replace HA in treating hypovolemia, with HS and MD demonstrating favorable side effect profiles compared to other options.

Impact:

• Provides guidance on selecting appropriate plasma expanders based on clinical indications and risk-benefit profiles.
• Highlights the therapeutic potential of synthetic colloids like HS and MD in critical care settings.
• Informs clinical practice regarding the use of volume substitutes, potentially reducing reliance on more expensive or riskier alternatives.