Crystalloids vs. Colloids in Surgical Hypovolemia

Immense concern has existed regarding the evidence that colloids, in particular starches, increase mortality and renal injury, especially in septic shock. A previous study in critical care however found no mortality difference ( link ). The present subgroup analysis was focussed on critically ill surgical hypovolemic shock needing surgery before or within 24 hours of ICU admission. Again, no difference in mortality or renal injury was found.

Nuances like differentiation between synthetic colloids and albumin, and potential benefits of balanced salt solutions were not addressed so once again, the debate will continue. In particular the results should not at this point be extrapolated to the different population of septic shock patients.

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