Question

Plasma expander: advantages and disadvantages.

Hint:

Plasma expanders should be used carefully, especially in patients with kidney disease or those at risk of fluid overload.

Answer 1

Step 1: Understanding Plasma Expanders.
Plasma expanders are solutions used to increase the blood volume, often following significant blood loss or during severe dehydration. They contain colloidal substances that draw water into the blood vessels, helping to restore circulatory volume. Examples of plasma expanders include albumin, dextran, and hydroxyethyl starch.

Step 2: Advantages of Plasma Expanders.


Effective Volume Expansion: Plasma expanders are particularly useful when rapid volume restoration is needed, such as in cases of shock or large blood loss.
Less Risk of Fluid Overload: Unlike crystalloids, which may require large volumes, plasma expanders tend to need smaller volumes to achieve the same effect.
Increased Oncotic Pressure: Plasma expanders increase the osmotic pressure of the blood, which helps maintain intravascular volume and perfusion pressure.

Step 3: Disadvantages of Plasma Expanders.


Risk of Allergic Reactions: Some plasma expanders, especially dextran, can cause allergic reactions or anaphylaxis.
Kidney Dysfunction: Overuse of plasma expanders, particularly in patients with renal impairment, can lead to kidney problems due to fluid shifts.
Cost: Plasma expanders can be more expensive compared to crystalloids, making them less cost-effective in certain clinical situations.

Step 4: Conclusion.
Plasma expanders play a critical role in volume resuscitation, especially in trauma or surgery, but they must be used judiciously due to their potential side effects.