Hypovolemia is the most common cause of circulatory failure in children and may
lead to critical tissue perfusion and eventually multiple-organ failure.
Administration of fluids to maintain or restore intravascular volume represents a
common intervention after hemorrhagic shock occurring during surgical procedures
or in patients with trauma. Notwithstanding, there is uncertainty whether the
type of fluid may significantly influence the outcome, especially in pediatrics.
Both human albumin and crystalloids are usually administered: the advantages of
crystalloids include low cost, lack of effect on coagulation, no risk of
anaphylactic reaction or transmission of infectious agents. However, large amount
of crystalloid infusion has been correlated with pulmonary oedema, bilateral
pleural effusions, intestinal intussusception, excessive bowel edema, impairing
closure of surgical wounds and peripheral edema. Moreover, intravascular volume
expansion obtained by crystalloids is known to be significantly shorter and less
efficacious than colloids. Among synthetic colloids, gelatins have been used for
many years in children, also in early infancy, to treat intravascular fluid
deficits. Hydroxyethylstarch (HES) preparations have been introduced recently,
becoming very popular for vascular loading both in adults and children. However,
the number of pediatric studies aimed at evaluating HES efficacy and tolerance is
limited. Given the ongoing controversies on the use of colloids in childhood,
this review will focus on the pharmacodynamics of synthetic and non synthetic
colloids for the treatment of critical blood loss in pediatrics.
|Numero di pagine||7|
|Rivista||CURRENT DRUG TARGETS|
|Stato di pubblicazione||Pubblicato - 2012|