Plasma Protein Therapeutics Association, 147 Old Solomon's Island Road, Annapolis, MD 21401, USA.
J Clin Pharmacol. 2011 Mar;51(3):292-300. doi: 10.1177/0091270010372107. Epub 2010 May 25.
Hypovolemia from a range of etiologies can lead to severe morbidity and mortality unless blood volume and tissue perfusion are restored. The treatment of hypovolemia has included the improvement and restoration of blood volume loss by the intravenous infusion of plasma expanding therapeutic agents. These have included crystalloid and/or colloid solutions, and a brisk controversy as to which modality is better has engaged therapeutics for the past 30 years. In addition, those favoring either modality have debated which crystalloid, and which colloid, is better. This area was given a dramatic turn a decade ago when a Cochrane meta-analysis concluded that albumin, a historically important plasma expander, resulted in increased mortality when administered to critically ill patients. Although subsequently modified by other studies, the Cochrane meta-analysis has served to generate an ongoing interest in the safety of plasma expanders. This review will assess the safety of these therapies from the viewpoint of the heterogeneous range of clinical indications for which they are used.
各种病因引起的低血容量可导致严重的发病率和死亡率，除非恢复血容量和组织灌注。低血容量的治疗包括通过静脉输注血浆扩容治疗剂来改善和恢复血容量丢失。这些包括晶体液和/或胶体溶液，在过去 30 年中，对于哪种方法更好的激烈争论一直困扰着治疗学。此外，那些赞成任何一种方法的人都在争论哪种晶体液和哪种胶体液更好。十年前，一项 Cochrane 荟萃分析得出结论，白蛋白是一种历史上重要的血浆扩容剂，在给危重症患者使用时会导致死亡率增加，这一领域发生了戏剧性的转变。尽管后来被其他研究修改，但 Cochrane 荟萃分析促使人们对血浆扩容剂的安全性持续关注。这篇综述将从它们所使用的各种临床适应证的角度评估这些治疗的安全性。
