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Colloids and Crystalloids

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Damage Control Resuscitation

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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.

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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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Authors and Affiliations

  1. Division of Trauma, Critical Care, and Acute Care Surgery, Oregon Health and Science University, Portland, OR, USA

    Arvin C. Gee & Martin A. Schreiber

Authors
  1. Arvin C. Gee
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  2. Martin A. Schreiber
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Correspondence to Martin A. Schreiber .

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Editors and Affiliations

  1. School of Medicine, Washington University in St. Louis, St. Louis, MO, USA

    Philip C. Spinella

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Gee, A.C., Schreiber, M.A. (2020). Colloids and Crystalloids. In: Spinella, P. (eds) Damage Control Resuscitation. Springer, Cham. https://doi.org/10.1007/978-3-030-20820-2_13

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  • DOI: https://doi.org/10.1007/978-3-030-20820-2_13

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-20819-6

  • Online ISBN: 978-3-030-20820-2

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