Colloids are theoretically retained in the intravascular space to a greater extent than crystalloids, which may have several benefits during resuscitation. First, intravascular volume can be expanded more rapidly. Second, a smaller total volume of fluid may be used to achieve adequate perfusion. Third, because there is potentially less thirdspacing,the risk of complications such as bowel edema, abdominal compartment syndrome (ACS), and acute respiratory distress syndrome (ARDS) may be decreased.However, numerous studies examining the use of colloids in resuscitation of the critically
ill and injured have failed to demonstrate a statistically significant benefit. A Cochrane review in 2002 comparing albumin with crystalloid resuscitation amonga mixed intensive care unit (ICU) population found that the relative risk (RR) of death
was higher with albumin than the comparison group (RR, 1.52; CI, 1.17–1.99), with a 5% absolute increase in the overall risk of death (14% compared with 9%).
Colloids are theoretically retained in the intravascular space to a greater extent than crystalloids, which may have several benefits during resuscitation. First, intravascular volume can be expanded more rapidly. Second, a smaller total volume of fluid may be used to achieve adequate perfusion. Third, because there is potentially less thirdspacing,the risk of complications such as bowel edema, abdominal compartment syndrome (ACS), and acute respiratory distress syndrome (ARDS) may be decreased.However, numerous studies examining the use of colloids in resuscitation of the criticallyill and injured have failed to demonstrate a statistically significant benefit. A Cochrane review in 2002 comparing albumin with crystalloid resuscitation amonga mixed intensive care unit (ICU) population found that the relative risk (RR) of deathwas higher with albumin than the comparison group (RR, 1.52; CI, 1.17–1.99), with a 5% absolute increase in the overall risk of death (14% compared with 9%).
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