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Colloids and Crystalloids

  • Arvin C. Gee
  • Martin A. SchreiberEmail author
Chapter

Abstract

Provision of intravenous fluids has been a long-standing mainstay in the resuscitation of traumatically injured persons. There has been mounting evidence this fluid resuscitation carries a risk of harm, particularly when given in large volumes. Although current strategy is for hemostatic resuscitation with blood products, colloid and crystalloid fluids are still commonly used in damage control resuscitation. A colloid solution is one that contains a dissolved high molecular weight compound that is intended to increase the oncotic pressure in the vasculature and increase the circulating volume by drawing water from extracellular space. Colloid use has been largely limited to albumin, hetastarch, and dextran solutions. Crystalloid solutions contain electrolytes and some have small molecule buffers. Each of these fluids has its own set of risks and benefits and indications for use.

Keywords

Colloids  Crystalloids  Hetastarch  Saline  Lactated Ringer’s 

Abbreviations

ARDS

Acute respiratory distress syndrome

ATLS

Advanced Trauma Life Support

DCR

Damage control resuscitation

FDA

Federal Drug Administration

HES

Hydroxyethyl starch

HSD

6% dextran-70 in 7.5% sodium chloride

HTS

Hypertonic saline

kDa

Kilodaltons

LR

Lactated Ringer’s

mEq/L

Milli-equivalents per liter

mmHg

Millimeters of mercury

mOsm/L

Milli-osmoles per liter

MW

Molecular weight

NS

Normal saline

RBC

Red blood cell

TCA

Tricarboxylic acid

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Division of Trauma, Critical Care, and Acute Care SurgeryOregon Health and Science UniversityPortlandUSA

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