Journal of Anesthesia

, Volume 24, Issue 6, pp 913–925

Colloid solutions: a clinical update

Review Article

DOI: 10.1007/s00540-010-1034-y

Cite this article as:
Niemi, T.T., Miyashita, R. & Yamakage, M. J Anesth (2010) 24: 913. doi:10.1007/s00540-010-1034-y

Abstract

Albumin, dextran, gelatin, and hydroxyethyl starch (HES) solutions are colloids that efficiently expand the circulating blood volume. The administration of colloids restores the intravascular volume with minimal risk of tissue edema in comparison with crystalloid solutions alone. However, colloids are always given for surgical and critically ill patients. The type of the colloid, volumes applied, aggressiveness of fluid resuscitation, and the volume status at the initial phase of administration determine their clinical responses. The outcome after fluid resuscitation with various colloids in critically ill patients seems to be comparable according to systematic reviews. A randomized, adequately powered clinical trial comparing modern nonprotein colloid to albumin is still lacking. Rapidly degradable HES solutions have good hemodynamic effects, and the risk of adverse renal and coagulation effects, as well as allergic reactions, is minimal. The current investigation has also shown the beneficial effect of HES solution (especially HES 130/0.4) on inflammatory response, postoperative nausea and vomiting, and postoperative outcome. The indication of colloids with an assessment of the degree of hypovolemia and safety profiles should thus be taken into consideration before colloid administration.

Keywords

Hydroxyethyl starch (HES) Molecular size Degree of substitution Intravascular volume 

Copyright information

© Japanese Society of Anesthesiologists 2010

Authors and Affiliations

  • Tomi T. Niemi
    • 1
  • Ryo Miyashita
    • 2
  • Michiaki Yamakage
    • 2
  1. 1.Department of Anaesthesiology and Intensive Care MedicineHelsinki University HospitalHelsinkiFinland
  2. 2.Department of Anesthesiology, Sapporo Medical University HospitalSapporo Medical University School of MedicineSapporoJapan

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