Date of Award
Master of Physician Assistant Studies
Physician Assistant Education
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.
Van Dyke, Gregory, "Consideration of Colloids and Crystalloids in Fluid Management" (2019). Physician's Assistant Program Capstones. 42.