The Colloid Crystalloid Question • Is one of the oldest. • Basic yet fundamental question. • The first intervention given. • To every patient. • Often several litres. A volume expander is a type of intravenous therapy that has the function of providing volume There are two main types of volume expanders: crystalloids and colloids. Crystalloids are aqueous solutions of mineral salts or other water- soluble. Colloids and crystalloids are types of fluids that are used for fluid replacement, often intravenously (via a tube straight into the blood).
|Published (Last):||6 October 2017|
|PDF File Size:||3.66 Mb|
|ePub File Size:||8.14 Mb|
|Price:||Free* [*Free Regsitration Required]|
Studies compared colloids starches; dextrans; gelatins; or albumin or FFP with crystalloids. N Engl J Med ; Colloids are more expensive than crystalloids. It may make little or no difference to the number of people who die if gelatins or crystalloids are used for fluid replacement.
We found moderate-certainty evidence that using starches probably slightly increases the need for blood transfusion. We found little or no difference in allergic reactions for the use of dextrans four studiesgelatins one studycriatalloidi albumin or FFP one study. Are particular types of colloid solution safer for replacing blood fluids than others? We found little or no difference between starches or crystalloids collodii allergic reactions, but fewer participants given crystalloids reported itching or rashes.
Data for RRT were not reported separately for gelatins 1 study. Goal-directed fluid therapy is possible with either crystalloid or HES. The body detects the lower hemoglobin level, and compensatory mechanisms start up.
Starches probably increase the need for blood transfusion and renal replacement therapy slightly. Physiological colloii is approximately 1.
There is also a risk of hemodilution, which may occur with crystalloid administration. Also, we found that some people cristalloidl were given crystalloids may also have had colloids, which might have affected the results. Cochrane Database Syst Rev.
When replacing blood loss, you need to administer approximately 3x estimated blood loss volume when using a crystalloid solution. Results from ongoing studies may increase our confidence in the evidence in future.
With enough blood loss, ultimately red blood cell levels drop too low for adequate tissue oxygenation, even if volume expanders maintain circulatory volume. One study comparing gelatins did not report results for renal replacement therapy according to the type of fluid given, and no studies comparing dextrans assessed renal replacement therapy.
Since the lost blood was replaced with a suitable fluid, the now diluted blood flows more easily, even in the small vessels. No difference in the incidence of postoperative complications was seen between the groups. Fourteen studies included participants in the crystalloid group who received or may have received colloids, which might have influenced results.
Albumin or FFP versus crystalloids We found moderate-certainty evidence that there is probably little or no difference between using albumin or FFP or using crystalloids in mortality at: Crystalloids are aqueous solutions of mineral salts or other water-soluble molecules.
When blood is lost, the greatest immediate need is to stop further blood loss. It could also lead to significant pulmonary edema, especially in patients with underlying cardiac systolic dysfunction or renal disease. We noted risk of selection bias in some studies, and, as most studies were not prospectively registered, crjstalloidi of selective crsitalloidi reporting. Starches probably slightly increase the need for blood transfusion and RRT moderate-certainty evidenceand albumin or FFP may make little or no difference to the need for renal replacement therapy low-certainty evidence.
Crystalloids are low-cost salt solutions e. Colloids, on the other hand, may rarely trigger an anaphylactic reaction. However, there is no evidence to cristallokdi that this results in less mortality than crystalloids.
NS is typically the first fluid used when hypovolemia is severe enough to threaten the cristallojdi of blood circulation, and has long been believed to be the safest fluid to give quickly in large volumes. Using starches, dextrans, albumin or FFP moderate-certainty evidenceor cristslloidi low-certainty evidenceversus crystalloids probably makes little or no difference to mortality. Colloids and crystalloids are types of fluids that are used for fluid replacement, often intravenously via a tube straight into the blood.
Certainty of the evidence Some study authors did not report study methods clearly and many did not register their studies before they started, so we could not be certain whether the study outcomes were decided before or after they saw colloiid results. We also found low-certainty evidence that using gelatins or crystalloids may make little or no difference to the number of deaths within each of these time points.
Gelatins versus crystalloids We found low-certainty evidence that there may ceistalloidi little or no difference between gelatins or crystalloids in mortality: Of note crystalloids are significantly cheaper than colloids.
Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.