Consideration of Colloids and Crystalloids in Fluid Management

Author

Gregory Van Dyke, University of the PacificFollow

Date of Award

3-1-2019

Document Type

Capstone

Degree Name

Master of Physician Assistant Studies

Department

Physician Assistant Education

First Advisor

Mark Christiansen

Abstract

The average adult is roughly comprised of 50-60% water that embodies the intracellular and extracellular space.1 Extracellular space is further broken into the interstitial, intravascular, and transcellular spaces. Because crystalloids are small molecules, most providers are concerned about the interstitial edema associated with revascularization. Critical illness causes inflammatory states that leads to endothelial dysfunction associated with interstitial edema. Since one significant downside of crystalloid administration is fluids crossing the permeable membrane, colloids can complete resuscitation without changing oncotic pressure and avoiding edema while increasing intravascular expansion. Due to the increased molecular weight and larger molecules associated with colloids, it is relatively impermeable to an intact capillary membrane.

Now that there are over sixty years of research on the topic, is there a consensus on what is more successful for fluid resuscitation? The goal of this literature review is to consider when colloid use is appropriate, and if so, is there any significant benefit that cannot be accomplished with crystalloid therapy alone.

Recommended Citation

Van Dyke, Gregory, "Consideration of Colloids and Crystalloids in Fluid Management" (2019). Physician Assistant Capstones. 42.
https://scholarlycommons.pacific.edu/pa-capstones/42