Наверное, лучше обратиться к первоисточникам, напр.:
Evidence-based Colloid Use in the Critically Ill: American Thoracic Society Consensus Statement. Am. J. Respir. Crit. Care Med. 170: 1247-1259(2004).
Summary Points
Colloids have various nononcotic properties that may influence vascular integrity, inflammation, and pharmacokinetics, although the clinical relevance of these properties has not been elucidated (NR).
All colloids affect the coagulation system, with dextran and starch solutions having the most potent antithrombotic effects (II-A).
HES may be deposited in the reticuloendothelial tissues for prolonged periods; the clinical significance of this is unknown (II-C).
Colloids restore intravascular volume and tissue perfusion more rapidly than crystalloids in all shock states, regardless of vascular permeability (II-A).
There is conflicting evidence that HES increases the risk of bleeding after cardiopulmonary bypass surgery (I).
Although hydrostatic pressure is more important than COP for accumulation of pulmonary edema, colloid administration reduces tissue edema and may ameliorate pulmonary edema as a consequence of shock resuscitation (II-A).
There is no evidence of a benefit of colloids in treating ischemic brain injury (I) or subarachnoid hemorrhage (II-A). Colloids may adversely impact survival in traumatic brain injury (I).
HES administration may increase the risk of acute renal failure in patients with sepsis (II-A).
Treatment of dialysis-related hypotension with colloids is superior to crystalloids for chronic dialysis patients; presumably, colloids are similarly superior for acutely ill patients (II-A).
Colloids are superior to crystalloids in intravascular volume replacement with large-volume paracentesis (II-A) and as adjunctive therapy to antibiotics in treating spontaneous bacterial peritonitis (II-A).
Meta-analyses of critical care colloid use are conflicting because of entry trial heterogeneity and varied analytic techniques, and a large prospective trial suggests a neutral influence of colloids on clinical outcomes.
Therapeutic Implications
Crystalloids should be administered first in nonhemorrhagic shock resuscitation (III).
Hydroxyethyl starch solutions should be used with caution in cardiopulmonary bypass (meta-analysis) and in patients with sepsis (II-A).
Colloids should be avoided or used with caution in patients with traumatic brain injury (I).
Fluid restriction is appropriate for patients with hemodynamically stable ALI/ARDS (II-A); the combination of colloids and diuretics may be considered in patients with hypo-oncotic ALI/ARDS (III).
Colloids are preferred for treating dialysis-associated hypotension and in maintaining hemodynamics to achieve dialysis goals (II-A).
Hyperoncotic albumin should be administered in conjunction with large-volume paracentesis for diuretic-refractory ascites (II-A).
Albumin may be administered in conjunction with antimicrobial therapy to patients with spontaneous bacterial peritonitis (II-A).
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