Description

This review attempts to give an overview of processes influenced by the choice of fluid therapy. Questions like Can manipulation of fluid resuscitation influence the inflammatory response to injury and organ function will be addressed. Results of randomised controlled prospective clinical studies suggest that limiting the sodium and chloride input and optimal use of synthetic colloids, which are well retained in the vascular space, can reduce the inflammatory response to injury and improve organ function. Morbidity and mortality increase as the patient’s haemodynamics deteriorate. Hence plasma volume replacement strategies are frequently used to normalise circulating volume. In addition to crystalloids, synthetic colloidals are widely used to achieve this goal. Crystalloids have a molecular weight under 30 kDa and are used to hydrate the tissues. Colloids have an average molecular weight above 30 kDa and remain predominantly within the intravascular space. Table 1 provides an  overview of crystalloids and colloids used in Europe. Composition, physical and chemical characteristics of these f luids are given in Table 2, which demonstrates the enormous diversity of colloids.