Physiology and Pharmacology. IV fluids vary in oncotic pressure, osmolarity, and tonicity. When the capillary membrane is intact, fluids containing colloid, such as albumin or hydroxyethyl starch, preferentially expand plasma volume rather than ICF volume.
Clinical Implications of Choices between Alternative Fluids. Despite the relative advantages and disadvantages, no evidence supports the superiority of either colloid-containing or crystalloid-containing solutions in influencing mortality (Table 14-14: Possible Advantages and Disadvantages of Colloid Versus Crystalloid Intravenous Fluids). There is no evidence that one colloid is more effective or safer than any other.
Implications of Crystalloid and Colloid Infusions on Intracranial Pressure. Despite a clinical notion, the risk of increased intracranial pressure seems to be independent of the selection of a crystalloid- or colloid-containing solution.
Clinical Implications of Hypertonic Fluid Administration. Hypertonic and hyperoncotic fluids seem most likely to be effective in the treatment of hypovolemic patients who have decreased intracranial compliance.