Colloid solutions: a clinical update.
Albumin, dextran, gelatin, and hydroxyethyl starch (HES) solutions are colloids that efficiently expand the circulating blood volume. The administration of colloids restores the intravascular volume with minimal risk of tissue edema in comparison with crystalloid solutions alone. However, colloids are always given for surgical and critically ill patients. The type of the colloid, volumes applied, aggressiveness of fluid resuscitation, and the volume status at the initial phase of administration determine their clinical responses. The outcome after fluid resuscitation with various colloids in critically ill patients seems to be comparable according to systematic reviews. A randomized, adequately powered clinical trial comparing modern nonprotein colloid to albumin is still lacking. Rapidly degradable HES solutions have good hemodynamic effects, and the risk of adverse renal and coagulation effects, as well as allergic reactions, is minimal. The current investigation has also shown the beneficial effect of HES solution (especially HES 130/0.4) on inflammatory response, postoperative nausea and vomiting, and postoperative outcome. The indication of colloids with an assessment of the degree of hypovolemia and safety profiles should thus be taken into consideration before colloid administration.
Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland.
Tomi T
TT
Niemi
Ryo
R
Miyashita
Michiaki
M
Yamakage
D000418:Albumins / Q000009:adverse effects / Q000627:therapeutic use; D001777:Blood Coagulation / Q000187:drug effects; D003102:Colloids / Q000009:adverse effects / Q000627:therapeutic use*; D003911:Dextrans / Q000009:adverse effects / Q000627:therapeutic use; D005780:Gelatin / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000009:adverse effects / Q000627:therapeutic use; D020896:Hypovolemia / Q000188:drug therapy; D007262:Infusions, Intravenous; D007677:Kidney Function Tests; D008970:Molecular Weight; D010952:Plasma Substitutes / Q000009:adverse effects / Q000627:therapeutic use*; D012996:Solutions; D012997:Solvents
D000418:Albumins; D003102:Colloids; D003911:Dextrans; D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D012996:Solutions; D012997:Solvents; D005780:Gelatin