I2i: Outline the ideal properties of a colloid IV fluid (25). Compare and contrast Gelatins, HES and 4% albumin (75)
Define
Colloid is a large molecular weight substance
Quantify
MW > 35,000 Da
In normal plasma, the plasma proteins are the major colloids
Function
Capillary fluid dynamics bc exert an osmotic force
Ideal Colloid
General
- Readily available
- Cheap
- Long shelf life
- No refrigeration
- Acceptable to all patients, no religious objections
- Contamination easy to detect
Physical
- Isotonic w plasma
- Iso-oncotic w plasma
PD
- Stays in intravascular compartment
PK
- T1/2 6-12h
- No metabolism
- No storage in body
AE
- No effect on organ fn
- No interference w coagulation
- No infection
- Does not disturb pH
Colloid
Dextran 70
Vol Exp %
100%
t1/2
6h
mOsm
306
Na
150
Cl
150
pH
6.0
Adverse Effects
Anaphylaxis
Alters coag
Renal dysfn
Colloid
Gelofusin
Vol Exp %
50%
t1/2
2.5h
mOsm
274
Na
150
Cl
120
pH
7.4
Adverse Effects
Anaphylactoid
Colloid
HES
(Voluven)
Vol Exp %
50%
t1/2
4h
mOsm
308
Na
154
Cl
154
pH
4-5.5
Adverse Effects
Coagulopathy
RCT- increased mortality and RRT in sepsis
Colloid
4% albumin
Vol Exp %
100%
t1/2
16h
mOsm
isoosmolar
Na
140
Cl
128
pH
7.2
Adverse Effects
Blood product, needs to be ordered, 2 clinician check,
Errors in processing, carries risk of disease transmission