Safety of plasma volume expanders.
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.
Farrugia
Albert
A
Plasma Protein Therapeutics Association, 147 Old Solomon's Island Road, Annapolis, MD 21401, USA. afarrugia@pptaglobal.org
D000818:Animals; D001778:Blood Coagulation Disorders / Q000188:drug therapy / Q000503:physiopathology; D003102:Colloids; D006023:Glycoproteins / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D020896:Hypovolemia / Q000188:drug therapy* / Q000209:etiology; D010952:Plasma Substitutes / Q000009:adverse effects* / Q000627:therapeutic use; D051437:Renal Insufficiency / Q000188:drug therapy / Q000503:physiopathology; D012709:Serum Albumin / Q000009:adverse effects / Q000627:therapeutic use; D000075462:Serum Albumin, Human
C422455:ALB protein, human; D003102:Colloids; D006023:Glycoproteins; D010952:Plasma Substitutes; D012709:Serum Albumin; D000075462:Serum Albumin, Human