title: Crystalloids and colloids in critical patient resuscitation.
abstract: Fluid resuscitation is essential for the survival of critically ill patients in shock, regardless of the origin of shock. A number of crystalloids and colloids (synthetic and natural) are currently available, and there is strong controversy regarding which type of fluid should be administered and the potential adverse effects associated with the use of these products, especially the development of renal failure requiring renal replacement therapy. Recently, several clinical trials and metaanalyses have suggested the use of hydroxyethyl starch (130/0.4) to be associated with an increased risk of death and kidney failure, and data have been obtained showing clinical benefit with the use of crystalloids that contain a lesser concentration of sodium and chlorine than normal saline. This new information has increased uncertainty among clinicians regarding which type of fluid should be used. We therefore have conducted a review of the literature with a view to developing practical recommendations on the use of fluids in the resuscitation phase in critically ill adults.
authors: Unidad Clínica de Cuidados Críticos y Urgencias, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, España. Electronic address: jgarnachom@gmail.com.
authors: J
authors: J
authors: Garnacho-Montero
authors: Servicio de Cuidados Críticos y Urgencias, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria ibs.Granada, Granada, España.
authors: E
authors: E
authors: Fernández-Mondéjar
authors: Servicio de Medicina Intensiva, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Terrassa, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Barcelona, España.
authors: R
authors: R
authors: Ferrer-Roca
authors: Unidad Clínica de Cuidados Críticos y Urgencias, Hospital Universitario Carlos Haya, Málaga, España.
authors: M E
authors: ME
authors: Herrera-Gutiérrez
authors: Departamento de Cuidados Intensivos, Hospital Universitario de Getafe, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Getafe, Madrid, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, España; Universidad Europea de Madrid, Madrid, España.
authors: J A
authors: JA
authors: Lorente
authors: Unidad de Medicina Intensiva, Hospital Universitario Dr. Negrín, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España.
authors: S
authors: S
authors: Ruiz-Santana
authors: Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Barcelona, España; Área de Críticos, Hospital de Sabadell, Corporación Sanitaria Universitaria Parc Taulí, Universidad Autónoma de Barcelona, Sabadell, Barcelona, España.
authors: A
authors: A
authors: Artigas
mesh_terms: D000138:Acidosis / Q000139:chemically induced / Q000209:etiology; D058186:Acute Kidney Injury / Q000139:chemically induced / Q000517:prevention & control / Q000628:therapy; D002986:Clinical Trials as Topic; D003102:Colloids / Q000009:adverse effects / Q000627:therapeutic use*; D000075202:Contraindications; D000077324:Crystalloid Solutions; D003911:Dextrans / Q000009:adverse effects / Q000627:therapeutic use; D004342:Drug Hypersensitivity; D005440:Fluid Therapy / Q000009:adverse effects; D005780:Gelatin / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000009:adverse effects / Q000627:therapeutic use; D007552:Isotonic Solutions / Q000009:adverse effects / Q000627:therapeutic use*; D015201:Meta-Analysis as Topic; D064887:Observational Studies as Topic; D017582:Renal Replacement Therapy; D012151:Resuscitation / Q000379:methods*; D000077325:Ringer's Lactate; D012462:Saline Solution, Hypertonic / Q000009:adverse effects / Q000627:therapeutic use; D012709:Serum Albumin / Q000009:adverse effects / Q000627:therapeutic use; D012769:Shock / Q000628:therapy*
chemical_list: D003102:Colloids; D000077324:Crystalloid Solutions; D003911:Dextrans; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D012462:Saline Solution, Hypertonic; D012709:Serum Albumin; D005780:Gelatin
keywords: Colloids; Coloides; Cristaloides; Crystalloids; Fluidos; Fluids