Pharmacology of colloids and crystalloids

Knowledge of the pharmacology, pharmacokinetics, and complications of the currently available crystalloid and colloid solutions assist the clinician in choosing the appropriate agent in the clinical setting. The proven benefits of commonly used solutions such as Ringer's lactate, human serum albumin, hetastarch, and dextran, as well as some of the less well-known fluids such as pentastarch, gelatins, and hypertonic saline are discussed. Specific toxicities for each agent include fluid overload with pulmonary and peripheral edema, allergic reactions, and hemostatic defects. An awareness of these issues allows for intelligent choices by clinicians.