Colloid Fluids

• do not pass across diffusional barriers as quickly as crystalloid
• greater tendency to remain in one space i.e. plasma
• principal benefit: more effective resuscitation of plasma volume
• these large solutes create colloid osmotic pressure aka oncotic pressure

ALBUMIN

• responsible for 75% oncotic pressure of plasma
• 5% soln similar in oncotic activity to plasma
• expands plasma volume 4-5x infusion volume, at expense of interstitial fluid volume; SO DON'T USE IN HYPOVOLEMIA (where ECF is decreased)
• intended to shift water from interstitium to vasculature in hypoproteinemic patients

HETASTARCH

• cheaper than albumin
• transient hyperAmylasemia due to cleavage by amylase enzymes.
• (lipase is nl: vs pancreatitis)

PENTASTARCH

• not approved in U.S.
• effective/safe volume expander

DEXTRANS

• unpopular due to perceived risk of adverse reactions

from The ICU Book, 2nd ed