Colloids and Crystalloids

Provision of intravenous fluids has been a long-standing mainstay in the resuscitation of traumatically injured persons. There has been mounting evidence this fluid resuscitation carries a risk of harm, particularly when given in large volumes. Although current strategy is for hemostatic resuscitation with blood products, colloid and crystalloid fluids are still commonly used in damage control resuscitation. A colloid solution is one that contains a dissolved high molecular weight compound that is intended to increase the oncotic pressure in the vasculature and increase the circulating volume by drawing water from extracellular space. Colloid use has been largely limited to albumin, hetastarch, and dextran solutions. Crystalloid solutions contain electrolytes and some have small molecule buffers. Each of these fluids has its own set of risks and benefits and indications for use.