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Kristalloide lassen sich in 0,9\u202f% Natriumchlorid (NaCl) und balancierte Kristalloide (BK) unterteilen. Kolloide k\u00f6nnen in k\u00fcnstliche\/artifizielle Kolloide und Humanalbumin (als nat\u00fcrliches Kolloid) unterteilt werden. Gro\u00dfe Studien konnten Vorteile von BK gegen\u00fcber 0,9\u202f% NaCl in Bezug auf renale Endpunkte zeigen, was vor allem durch den unphysiologisch hohen Chloridgehalt in 0,9\u202f% NaCl bedingt sein d\u00fcrfte. Weitere Studien wie BaSICS und PLUS Trial zeigten an einem heterogenen Kollektiv keine signifikanten Unterschiede in der Mortalit\u00e4t. Jedoch deuten Metaanalysen auf Vorteile der BK hin. Insbesondere bei Patient:innen mit erh\u00f6htem Risiko f\u00fcr eine akute Nierensch\u00e4digung, Azidose und\/oder Hyperchlor\u00e4mie sollten daher prim\u00e4r BK verwendet werden. Au\u00dfer f\u00fcr spezielle Indikationen, so etwa bei Patient:innen mit Leberzirrhose oder \u201eresuscitation\u201c in der Sepsis nach initialer Volumentherapie mit BK, sollte Albumin nicht eingesetzt werden. Andere, artifizielle, Kolloide sollten mit Zur\u00fcckhaltung verabreicht werden. F\u00fcr Hydroxyethylst\u00e4rke gibt es eindeutige Sch\u00e4digungssignale bei Intensivpatient:innen.<\/jats:p>","DOI":"10.1007\/s00063-024-01194-0","type":"journal-article","created":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T09:01:47Z","timestamp":1728464507000},"page":"640-649","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Volumentherapie \u2013 welches Pr\u00e4parat in welcher Situation?","Volume therapy: which preparation for which situation?"],"prefix":"10.1007","volume":"119","author":[{"given":"Timo","family":"Mayerh\u00f6fer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg F.","family":"Lehner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Joannidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,9]]},"reference":[{"key":"1194_CR1","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1007\/978-3-031-42205-8_2","volume-title":"Rational Use of Intravenous Fluids in Critically Ill Patients","author":"T Woodcock","year":"2024","unstructured":"Woodcock\u00a0T (2024) Fluid Physiology Part\u00a01: Volume and Distribution of Water and Its Major Solutes Between Plasma, the Interstitium and Intracellular Fluid. 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