[Is there a means for cost reduction in intensive care fluid therapy without a loss of quality?].
Cost reduction in fluid therapy may be possible without a loss in quality of medical therapy if the following principles are adhered to. 1: Compare the prices of different manufacturers. 2: The greater the product unit, the cheaper the milliliter. Adherence to this principle is limited by hygienic and logistic considerations. 3: 0.9% NaCl-solution is cheaper than Ringer's lactate-solution. Lactated Ringer's solution should be used, only, if there are contraindications against the higher solute concentrations and tonicity of 0.9% NaCl. 4: Crystalloids are cheaper than colloids. When choosing between these two options intravasal duration of action and specific adverse events must be considered. 5: Cost reduction by differential indication of artificial colloids. Comparing prices, one must consider risk of anaphylactoid/anaphylactic reactions, duration of action, limitation of dosage and possible hemostasis disorders. 6: Restrictive use of albumin. Albumin is the most expensive colloid. There are no reasons for routine use.
Prien
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Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Westfälischen Wilhelms-Universität Münster.
Singbartl
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D002626:Chemistry, Pharmaceutical; D003363:Cost Control; D003422:Critical Care / Q000191:economics* / Q000592:standards*; D006801:Humans; D007262:Infusions, Intravenous / Q000191:economics* / Q000592:standards*; D011786:Quality Control
Ist eine Kostenreduktion in der Flüssigkeitstherapie bei Wahrung der Qualität in der Intensivtherapie möglich?