Blutkomponenten Und Plasmaersatzmittel
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Korperfremde und korpereigene kolloidale Infusionsmittel haben vorrangig in der Notfallmedizin und in der Substitutionstherapie bei definierten humoralen Immundefekten ihren festen Platz. Die heterologen Plasmaersatzmittel bestehen aus Fremdkolloiden wie Dextran, Gelatine und Hydroxyathylstarke und unterschei den sich untereinander deutlich in ihren physikochemischen Eigenschaften, dem Molekulargewicht, dem Volumeneffekt, der Verweildauer und in ihren Nebenwirkungen. Bei Blutverlusten treten sie an die Stelle der Plasmaproteine und gewahrleisten ein ausreichendes intravasales Volumen. Ausserdem haben sie Ein fluss auf rheologische und gerinnungsphysiologische Parame ter. Homologe kolloidale Infusionsmittel, wie die Serumkonserve oder die durch Fraktionierung gewonnenen Plasmaderivate (Plas maproteinlosungen [PPL], Humanalbumin sowie Immunglobuli ne), haben zusatzliche Eigenschaften, die therapeutisch genutzt werden konnen. Hauptsachlich ihre Indikationen und Anwen dungsbereiche wurden auf dem mit Unterstutzung der Firma Bio test Pharma GmbH im Mai 1981 durchgefuhrten Symposium in Einzelvortragen dargestellt. Von besonderem Interesse war erneut, Indikationsbereiche fur eine passive Immuntherapie zu diskutieren, wobei diesmal nicht die unterschiedlichen Immunglobulinpraparationen im Mittel punkt standen, sondern die Besprechung der physikochemischen Eigenschaften und die klinische Anwendung der Serumeiweiss konserve den Vorrang hatte. Wie die Diskussion zeigte, stellt die Serumeiweisskonserve eine wertvolle Alternative zu der Anwen dung von intravenos applizierten Immunglobulinpraparationen dar. Hierbei werden dem Organismus ausser Immunglobulinen auch wertvolle und notwendige Transportproteine bereitgestellt. Dabei ist die Hepatitissicherheit des kommerziellen Praparats ein entscheidendes Kriterium. V Spezielle Indikationen fur die Applikationen von Immunglobuli nen bleiben jedoch weiter bestehen und wurden besprochen. Auch der Einfluss von intravenos applizierten Immunglobulinen auf zellvermittelte Immunreaktionen wurde dargestellt."
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