Crystalloids or Colloids?

In an emergency setting, which one would be the better choice?

Seriously, I can’t be bothered with all the statistics that researchers produce in their papers about which is superior than the other.

Every individual is different and their needs should be tailored. Decision is not made based on some research papers who knows nuts about your patient more than you do.

I’ll list down the advantages and disadvantages of both the solution.

Cystalloids

Advantanges:

  • It’s cheap.
  • Easily available.
  • No anaphylactic effects.

Disadvantages:

  • Stays for a short period of time in the intravascular compartment.
  • More is needed to achieve euvolaemic status. 3 times more as compared to colloids.

Colloids

Advantages:

  • Stays longer in the intravascular compartment.
  • Less amount is needed.

Disadvantages:

  • More expensive.
  • Produce anaphylatic effects in certain individuals.
  • Interferes with blood grouping and cross-matching.

Points to take note…

  1. If someone has sepsis or burns… do not resuscitate with colloids. Both sepsis and burns produce leaky capillaries. The colloid molecules would just leak into the interstitial space. It does not play its role as an intravascular volume expander. It produces an osmotic effect in the interstitial space instead and causes oedema.
  2. If blood has not been taken for grouping and cross-matching, don’t bother using colloids.
  3. If patient is severely in shock, giving crystalloid may not be fast enough. Use colloids instead. It’ll buy you some time.

Fluid Therapy for the Needy

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