[Infusiontherapy with colloidal volumesubstitutes (author's transl)]

Area of Science:

• Anesthesiology
• Pharmacology
• Critical Care Medicine

Background:

• Colloidal plasma substitutes are crucial for volume replacement therapy.
• Anaphylactoid reactions are a known risk associated with colloid administration.
• Human albumin solutions are among the colloids that can cause severe complications.

Purpose of the Study:

• To evaluate the risk of anaphylactoid complications associated with colloidal plasma substitutes.
• To emphasize the importance of considering solution-specific risks when selecting colloids.
• To highlight the irreplaceable antithrombotic properties of dextran.

Main Methods:

• Review of incidence rates of anaphylactoid complications.
• Consideration of clinical case reports and historical trial data.
• Assessment of the role of dextran in volume replacement and thromboprophylaxis.

Main Results:

• The general incidence of anaphylactoid complications from colloids is 0.03%.
• Severe reactions can occur despite the seemingly low incidence.
• Recent case reports suggest an increased rate, though not substantiated by older trials.
• Dextran offers volume expansion and antithrombotic effects.

Conclusions:

• Colloids remain indispensable in volume replacement therapy despite potential anaphylactoid risks.
• The choice of colloid should account for its specific risk profile for anaphylactoid reactions.
• Dextran's unique antithrombotic properties necessitate its continued use or replacement with a thromboprophylactic agent.