Managing Complications in Pregnancy and Childbirth: - IAWG

Clinical use of blood, blood products and replacement fluidsC-33COLLOID FLUIDS• Colloid solutions are composed of a suspension of particles thatare larger than crystalloids. Colloids tend to remain in the bloodwhere they mimic plasma proteins to maintain or raise the colloidosmotic pressure of blood.• Colloids are usually given in a volume equal to the blood volumelost. In many conditions where the capillary permeability isincreased (e.g. trauma, sepsis), leakage out of the circulation willoccur and additional infusions will be necessary to maintain bloodvolume.Points to remember:• There is no evidence that colloid solutions (albumin, dextrans,gelatins, hydroxyethyl starch solutions) have advantages overnormal saline or balanced salt solutions for resuscitation.• There is evidence that colloid solutions may have an adverse effecton survival.• Colloid solutions are much more expensive than normal saline andbalanced salt solutions.• Human plasma should not be used as a replacement fluid. All formsof plasma carry a similar risk as whole blood of transmittinginfection, such as HIV and hepatitis.• Plain water should never be infused intravenously. It will causehaemolysis and will probably be fatal.There is a very limited role for colloids in resuscitation.SAFETYBefore giving any IV infusion:• check that the seal of the infusion bottle or bag is not broken;• check the expiry date;• check that the solution is clear and free from visible particles.MAINTENANCE FLUID THERAPYMaintenance fluids are crystalloid solutions, such as dextrose ordextrose in normal saline, used to replace normal physiological losses