[Qualities and application of macromolecular volume substitutes (author's transl)].

The effective volume substitution in shock requires normalizing of the circulating blood volume as well as the restitution of microcirculation. Saline solutions are unsuited for their missed oncotic efficiency and their short intravenous staying. Also stored blood is unsuitable because of its rheological properties, plasma protein preparations for economical and infectious reasons. The different qualities and effects of the known plasma substitutes on the basis of dextran, gelatine and starch are described, their special indications being explained. Haemodilution and the so-called secondary effects limit the dosage of volume substitution.