Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 8 , ISSUE 1 ( March, 2004 ) > List of Articles


Colloid versus crystalloids in shock

Ken Hillman

Keywords : Shock, Fluid resuscitation, Colloids, Crystalloids

Citation Information : Hillman K. Colloid versus crystalloids in shock. Indian J Crit Care Med 2004; 8 (1):14-21.

DOI: 10.5005/ijccm-8-1-14

License: CC BY-ND 3.0

Published Online: 01-06-2009

Copyright Statement:  Copyright © 2004; The Author(s).


This is a review of the use of colloid and crystalloid in shock. The article discusses the pathophysiological consequences of ischaemia and shock; reviews the underlying physiology of fluid compartments and how they may be affected by disease; examines the physiological determinants of intravenous (IV) fluid use; and finally reviews the literature on colloid and crystalloid use for the management of shock.

PDF Share
  1. The crystalloid versus colloid controversy: Present status. In: Halkjamae H, editor. Baillier′s Clinical Anaesthesiology. International Practice and Research. Plasma Volume Support. London: Bailliere Tindall; 1997;11:1-13. ISBN 0-7020-2341-8.
  2. Hemodynamic and metabolic effects of hemorrhage in man, with particular reference to the splanchnic circulation. Circulation Research 1966;18:469-74.
  3. Occurrence of bacteremia during and after hemorrhagic shock: Efficacy and cardiopulmonary consequences. Crit Care Med 1988;28:10-6.
  4. Splanchnic ischaemia/reperfusion and multiple organ failure. Br J Anaesth 1996;77:59-70.
  5. Intra-operative gut mucosal hypoperfusion is associated with increased post-operative complications and cost. Intensive Care Med 1994;20:99-104.
  6. Splanchnic perfusion in shock. Intensive Care med 1994;20:403-4.
  7. The bacterial factor in hemorrhagic shock. Surg Gynae Obstet 1992;175:285-92.
  8. Research in sepsis and acute respiratory distress syndrome: Are we changing course? Crit Care Med 1999;27:434-6.
  9. Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 1994;331:1105-9.
  10. Fluids and electrolytes. In: Scurr C, Felman S, Soni N, editors. Scientific Foundations of Anaesthesia, 4th Ed. Heinemann: Medical Books; 1990. p. 448-62.
  11. Cardiac output measurement using femoral artery thermodilution in patients. J Crit Care 1989;4:106-11.
  12. Comparison of pulmonary arterial and arterial thermodilution cardiac output in critically ill patients. Intensive Care Med 1999;25:843-6.
  13. Intrathoracic blood volume accurately reflects circulatory volume status in critically ill patients with mechanical ventilation. Intensive Care Med 1992;18:137-8.
  14. What value does the recording of intrathoracic blood volume have in clinical practice? Intensive Care Med 1992;18:137-8.
  15. Bedside estimation of extravascular lung water in critically ill patients: Comparison of the chest radiograph and the thermal dye technique. Intensive Care Med 1984;10:309-13.
  16. New concepts in the diagnosis and fluid treatment of circulatory shock. Anesth Analg 1979;58:124-32.
  17. Circulatory disorders: Intervention and control. Measurement in Medicine 1986;1:313.
  18. The origins of intravenous fluid therapy. Lancet 1989;i:768-71.
  19. Studies of the circulation in clinical shock. Surgery 1943;13:964-95.
  20. Acute changes in extracellular fluids associated with major surgical procedures. Ann Surg 1961;154:803-10.
  21. The end of the crystalloid era? A new approach to peri-operative fluid administration. Anaesthesia 1985;40:860-71.
  22. Some aspects of pulmonary function after rapid saline infusion in health subjects. Clinical Science 1973;45:4907-10.
  23. Comparison of the relative effectiveness of whole blood transfusions and various types of fluid therapy in resuscitation. Crit Care Med 1976;4:71-8.
  24. Oxygen transport responses to colloids and crystalloids in critically ill surgical patients. Surg Gyne Obstet 1980;150:811-6.
  25. Superiority of colloid over electrolyte solutions for fluid resuscitation (sever normovolemic hemodilution). Crit Care Med 1981;9:369-70.
  26. Fluid resuscitation in circulatory shock: A comparison of the cardiorespiratory effects of albumin, hetastarch, and saline solutions in patients with hypovolemic and septic shock. Crit Care Med 1983;11:839-50.
  27. Mesenteric oxygen metabolism, ileal mucosal hydrogen ion concentration, and tissue edema after crystalloid or colloid resuscitation in porcine endotoxic shock: Comparison of Ringer′s lactate and 6% hetastarch. Circulatory Shock 1990;30:385-97.
  28. Statistical evaluation of plasma substitutes based on 10 variables. Crit Care Med 1982;10:653-7.
  29. Colloids versus crystalloids and tissue oxygen tension in patients undergoing major abdominal surgery. Anesth Analg 2001;90:1247-9.
  30. Effect of varying oxygen tensions on healing of open wounds. Surg Gyne Obstet 1972;135:756.
  31. The development and use of equations for predicting limits on the rates of oxygen supply to the cells of tissues and organs. Angiology 1969;20:61.
  32. Postoperative deep vein thrombosis caused by intravenous fluids during surgery. Br J Surg 1980;67:690-3.
  33. In vivo effect of haemodilution with saline on coagulation: A randomized controlled trial. Br J Anaesth 2002;88:475-80.
  34. Hyperchloremic metabolic acidosis is a predictable consequence of intraoperative infusion of 0.9% saline. Anesthesiology 1999;90:1247-9.
  35. Early postoperative respiratory acidosis after large intravascular volume infusion of lactated Ringer′s solution during major surgery. Anesth Analg 2002;95:294-8.
  36. Interstitial fluid pressure. Physiology Review 1971;51:527.
  37. Hemodynamic effects of colloid concentration in experimental hemorrhage. A comparison of Ringer′s lactate, 3% dextran-40 and 6% dextran-70. Crit Care Med 1988;16:346.
  38. Splanchnic and total body oxygen consumption in experimental fecal peritonitis in pigs: Effects of dextran and iloprost. Circulatory Shock 1992;36:299-306.
  39. Redistribution of organ blood flow after hemorrhage and resuscitation in full-term piglets. J Ped Surg 1994;29:1097-102.
  40. Perioperative plasma volume expansion reduces the incidence of gut mucosal hypoperfusion during cardiac surgery. Arch Surg 1995;130:423-9.
  41. Pulmonary edema during volume infusion. Circulation 1975;52:483-9.
  42. Compared effects of selected colloids on extravascular lung water in dogs after oleic acid-induced lung injury and severe hemorrhage. Crit Care Med 1983;11:267-70.
  43. Hemodynamic and colloid osmotic pressure alternations in the surgical patient. Crit Care Med 1983;11:191-5.
  44. Effects of albumin versus non-albumin resuscitation on plasma volume and renal excretory function. J Trauma 1978;18:564-70.
  45. Balanced electrolye solutions: Experimental and clinical studies. Crit Care Med 1979;7:98-106.
  46. Volume replacement in hemorrhage, shock and burns. Advances in Shock Research 1980;3:47-56.
  47. Comparisons of colloids and crystalloids in resuscitation from hemorrhagic shock. Surg Gyne Obstet 1982;154:577-86.
  48. Parenteral fluid therapy in septic shock: An evaluation of crystalloid and colloid. American Surgeon 1974;40:542-7.
  49. Hemodilution and recovery from experimental intestinal shock in rates: A comparison of the efficacy of three colloids and one electrolyte solution. Crit Care Med 1981;9:42-6.
  50. Comparison of the relative effectiveness of colloids and crystalloids in emergency resuscitation. Am J Surg 1981;9:367-68.
  51. Advantages of dextran 70 over Ringer acetate solution in shock treatment and in prevention of adult respiratory distress syndrome. A randomised study in man after traumatic hemorrhagic shock. Resuscitation 1983;10:219-26.
  52. Crystalloid versus colloid fluid resuscitation: A meta-analysis of mortality. Surgery 1989;105:65-71.
  53. Fluid resuscitation with colloids or crystalloids in critically ill patients: A systematic review of randomised trials. Br Med J 1998;316:961-4.
  54. Human albumin administration in critically ill patients - systematic review of randomised controlled trial. BMJ 1998;317:235-40.
  55. Patient survival after human albumin administration - a meta-analysis of randomised controlled trials. Ann Intern Med 2001;135:149-64.
  56. Crystalloid-colloid controversy revisited. Crit Care Med 1999;27:34-5.
  57. Editorial: Colloid use for fluid resuscitation: evidence and spin. Ann Intern Med 2001;135:205-8.
  58. Crystalloids vs colloids in fluid resuscitation: A systematic review. Crit Care Med 1999;27:200-10.
  59. Gastric intramucosal pH as a therapeutic index of tissue oxygenation in critically ill patients. Lancet 1992;339:195-9.
  60. Elevation of systemic oxygen delivery in the treatment of critically ill patients. New Engl J Med 1994;330:1717-22.
  61. Prospective, randomised trial of survivor values of cardiac index, oxygen delivery, and oxygen consumption as resuscitation endpoints in severe trauma. J Trauma 1995;38:780-7.
  62. Prospective trial of supranormal values as goals of resuscitation in severe trauma. Arch Surg 1992;127:1175-81.
  63. Effect of maximizing oxygen delivery on morbidity and mortality rates in critically ill patients: A prospective, randomised, controlled study. Crit Care Med 1993;21:830-8.
  64. Research in sepsis and acute respiratory distress syndrome: Are we changing course? Crit Care Med 1999;27:434-6.
  65. Antibodies to TNF-á: Too little, too late? Crit Care Med 1998;26:1625-6.
  66. Why immunomodulatory therapies have not worked in sepsis. Intensive Care Med 1999;25:556-66.
  67. Post hoc analyses in sepsis trials. A formula for disappointment? Crit Care Med 1996;24:727-9.
  68. Redefining in-hospital resuscitation: The concept of the medical emergency team. Resuscitation 2001;48:105-10.
  69. The medical emergency team. Anaesth Intensive Care 1995;23:183-6.
  70. The medical emergency team: A new strategy to identify and intervene in high risk patients. Clin Intensive Care 1995;6:269-72.
  71. Identifying the general ward patient at high risk of cardiac arrest. Clin Intensive Care 1996;7:242-3.
  72. The changing role of acute-care hospitals. Med J Aust 1999;7:242-3.
  73. Recognising and preventing serious in-hospital events. Med J Aust 1999;171:308-9.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.