Colloids and crystalloids may have similar effects on mortality when used for fluid replacement in critically ill patients

Abstract

What is this? Some patients with COVID-19 will become critically ill and may need additional fluids to prevent kidney failure. Fluid replacement options include colloids or crystalloids. Colloids are cheap and easy to use but may increase oedema. Crystalloids cost more, provide swifter volume expansion, but may cause allergic reactions, blood clotting disorders and kidney failure. In this Cochrane systematic review, the authors searched for randomized and quasi-randomized trials, which compared colloid (starches, dextrans, albumin or Fresh Frozen Plasma (FFP)) with crystalloid (isotonic or hypertonic) solutions in patients who were critically ill because of trauma, burns or sepsis and required fluid volume replacement. They did not restrict by date, type or language of publication and did their searches in February 2018. They identified 65 randomised trials and 4 quasi- randomised trials (approximately 30,000 participants). The trials evaluated starch solutions, dextrans, gelatins and albumin or FFP.