Context Measurement of blood haemoglobin (Hb) concentration by pulse oximetry (SpHb) could be of value to determine when erythrocytes should be transfused during surgery, but the effect of infusion fluids on the results is unclear. Objective To study the effect of crystalloid and colloid fluid on the accuracy (bias) and precision of SpHb to indicate the venous Hb concentration in volunteers. De...

Plasma volume expanders--crystalloid, colloid, or a mixture of both--are used as fluid replacement in patients who have postoperative hypovoloaemia. Despite numerous clinical trials there is little evidence that either classification of plasma volume expander is more beneficial to mortality than the other.

BACKGROUND Colloid solutions are widely used in fluid resuscitation of critically ill patients. There are several choices of colloid and there is ongoing debate about the relative effectiveness of colloids compared to crystalloid fluids. OBJECTIVES To assess the effects of colloids compared to crystalloids for fluid resuscitation in critically ill patients. SEARCH STRATEGY We searched the C...

The majority of burn centres use the crystalloid-based Parkland formula to guide fluid therapy, but patients actually receive far more fluid than the formula predicts. Resuscitation with large volumes of crystalloid has numerous adverse consequences, including worsening of burn oedema, conversion of superficial into deep burns, and compartment syndromes. Resuscitation fluids influence the infla...

BACKGROUND The optimal crystalloid solution to use perioperatively in patients undergoing open radical cystectomy remains unclear. Many of the fluids used for intravenous hydration contain supraphysiologic concentrations of chloride, which can induce hyperchloremia and metabolic acidosis, resulting in renal vasoconstriction and decreased renal function. In addition, patients receiving less flui...

BACKGROUND Goal-directed fluid therapy has been shown to improve outcomes after colorectal surgery, but the optimal type of i.v. fluid to use is yet to be established. Theoretical advantages of using hydroxyethyl starch (HES) for goal-directed therapy include a reduction in the total volume of fluid required, resulting in less tissue oedema. Recent work has demonstrated that new generations of ...

BACKGROUND Hydroxyethyl starch (HES) was part of "triple-H" therapy for prophylaxis and therapy of vasospasm in patients with subarachnoid haemorrhage (SAH). The European Medicines Agency restricted the use of HES in 2013 due to an increase of renal failure in critically ill patients receiving HES compared to crystalloid fluids. The occurrence of renal insufficiency in patients with SAH due to ...

Volume kinetics is a method used for analyzing and simulating the distribution and elimination of infusion fluids. Approximately 50 studies describe the disposition of 0.9% saline, acetated and lactated Ringer's solution, based on repeated measurements of the hemoglobin concentration and (sometimes) the urinary excretion. The slow distribution to the peripheral compartment results in a 50-75% l...

Stewart's quantitative physical chemical approach enables us to understand the acid-base properties of intravenous fluids. In Stewart's analysis, the three independent acid-base variables are partial CO2 tension, the total concentration of nonvolatile weak acid (ATOT), and the strong ion difference (SID). Raising and lowering ATOT while holding SID constant cause metabolic acidosis and alkalosi...

PURPOSE OF REVIEW To highlight some of the recent key issues surrounding crystalloid and colloid fluid management of critically ill patients. RECENT FINDINGS Significant developments have been made in the understanding of ionic balance of fluids and their effects on acid-base, the role of hydration and overhydration, alkalinization of fluids in patients at high risk for contrast induced nephr...