Crystalloids or Colloids for the Treatment of Hypovolemia?

Abstract

( P ag e 1 2 ) TATM 1999;4:12-26 • Hemodynamic

The Role of Albumin in the Resuscitation of Hypotensive Patients

“…It does not appear to be ideal to use as a primary resuscitation fluid owing to the fact that it is not shelf-stable (needs to be used within 24 h of thawing), and moreover has an increased risk of both immunogenic and non-immunogenic complications, such as transfusion-associated circulatory overload, hemolytic transfusion reactions due to failure of ABO matching, and transmission of infectious agents such as HIV, hepatitis B, and hepatitis C [12]. Dextrans comprise a group of single chain polymers of bacterial origin, prepared in 40 kD, 60 kD, and 70 kD formulations [13]. Use of dextrans has declined in recent years due to their association with osmotically mediated renal injury [14,15], anaphylactoid reactions [16], and increased bleeding risk from impaired platelet aggregation and decreased levels of factor VIII and von Willebrand factor [17].…”

“…Use of dextrans has declined in recent years due to their association with osmotically mediated renal injury [14,15], anaphylactoid reactions [16], and increased bleeding risk from impaired platelet aggregation and decreased levels of factor VIII and von Willebrand factor [17]. HES preparations are composed of natural polysaccharides that have been chemically modified by hydroxyethylation to stabilize the solution against alpha-amylase degradation in vivo [13]. Use of HES solutions have declined over the years due to reports of increased risk of renal injury [18][19][20] and altered hemostasis conferring increased bleeding risk [17,21].…”