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Place of the colloids in fluid resuscitation of the traumatized patient.

AbstractPURPOSE OF REVIEW:
The examination of the recent literature aimed at analysing the most recent data that could affect decisions regarding the use of colloids in trauma resuscitation.
RECENT FINDINGS:
Animal data have generally shown a beneficial effect of colloids in trauma resuscitation, with improvements in capillary leak demonstrated in lung, intestine and brain. In most studies, hydroxyethyl starch resuscitation was more effective than crystalloid and decreased markers of inflammatory processes were observed. Brain injury in animals was attenuated with colloids. In uncontrolled haemorrhage, resuscitation with colloid increased bleeding and mortality.Human studies have also failed to confirm the suggestion that albumin resuscitation may be associated with a worse outcome in head injury. However, there is a strong suggestion that aggressive prehospital resuscitation, particularly with colloid, may be harmful. Studies in burns have consistently shown an improvement in the tendency to fluid overload with the inclusion of colloid in the resuscitation strategy, but so far no outcome benefit has been shown.Two studies of general trauma resuscitation have shown apparent benefit from the use of HES in early resuscitation with reductions in mortality and in renal injury.
SUMMARY:
Recent trauma studies provide ongoing, but not conclusive, evidence of a benefit from colloid resuscitation in trauma.
AuthorsMichael F M James
JournalCurrent opinion in anaesthesiology (Curr Opin Anaesthesiol) Vol. 25 Issue 2 Pg. 248-52 (Apr 2012) ISSN: 1473-6500 [Electronic] United States
PMID22193153 (Publication Type: Journal Article, Review)
Chemical References
  • Albumins
  • Colloids
  • Hydroxyethyl Starch Derivatives
Topics
  • Albumins (administration & dosage)
  • Animals
  • Burns (therapy)
  • Colloids (administration & dosage)
  • Craniocerebral Trauma (therapy)
  • Fluid Therapy (methods)
  • Humans
  • Hydroxyethyl Starch Derivatives (administration & dosage)
  • Resuscitation (methods)
  • Wounds and Injuries (therapy)

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