Osmotherapy

from Wikipedia, the free encyclopedia

In osmotherapy , osmotically active substances are supplied to the body by means of intravenous infusions. As a rule, these are highly concentrated solutions of sugar alcohols (e.g. mannitol , sorbitol ). Due to their high osmotic pressure , they should bind fluids that have accumulated in the tissue so that they can be excreted through the kidneys. Edema can be treated by removing water. The previously broader areas of application of osmotherapy ( pulmonary edema , bronchitis or fresh serous pleurisy ) have been restricted in their indications due to the stress on the right heart . The osmotherapy is the especially for the treatment of of crisis increase intracranial pressure (intracranial pressure ICP applied). In the traumatic brain injury mannitol is the first choice and seems mortality when used to lower a controlled means of pressure measurement indication. Osmotherapy should be avoided in the event of mass cerebral bleeding .

Further areas of application are the lowering of an acutely increased intraocular pressure ( glaucoma ) and the maintenance of the urine flow in the event of an impending kidney failure. The targeted initiation of an osmotic diuresis can be carried out in the diagnosis of insufficient urine production ( oliguria , anuria ).

Historical

In 1920, Max Bürger and Erich Hagemann described the process of artificial pressure difference between tissue. The procedure was e.g. B. successfully used in warfare agent poisoning in the First World War and served for detoxification and also for the treatment of pulmonary and brain edema .

literature

  • Bürger and Hagemann: About osmotherapy . German Medical Weekly , 1921, No. 8
  • Roche Lexicon Medicine, page 1378 Elsevier, Urban & Fischer Verlag, 2003 ISBN 3437151509
  • Wallesch Neurology: Diagnostics and Therapy in Clinic and Practice Elsevier, Urban & Fischer Verlag, 2005, ISBN 3437233904
  • Ernst Mutschler, Gerd Geisslinger, Heyo K. Kroemer, Peter Ruth, Monika Schäfer-Korting: drug effects. Textbook of pharmacology and toxicology. 9th edition. Wissenschaftliche Verlagsgesellschaft mbH, Stuttgart 2008, ISBN 3-80-471952-X

Web links