Colloids and the Microcirculation

Colloid solutions have been advocated for use in treating hypovolemia due to their expected effect on improving intravascular retention compared with crystalloid solutions. Because the ultimate desired effect of fluid resuscitation is the improvement of microcirculatory perfusion and tissue oxygenation, it is of interest to study the effects of colloids and crystalloids at the level of microcirculation under conditions of shock and fluid resuscitation, and to explore the potential benefits of using colloids in terms of recruiting the microcirculation under conditions of hypovolemia. This article reviews the physiochemical properties of the various types of colloid solutions (eg, gelatin, dextrans, hydroxyethyl starches, and albumin) and the effects that they have under various conditions of hypovolemia in experimental and clinical scenarios. Accepted for publication September 27, 2017. Funding: H.H. received funding from the China Scholarship Council (No. 201608110082) and the Organization Department of Beijing Municipal Committee (No. 2015000020124G072). C.I. has received honoraria and independent research grants from Fresenius-Kabi, Bad Homburg, Germany, and Baxter HealthCare, Deerfield, IL. The authors declare no conflicts of interest. Reprints will not be available from the authors. Address correspondence to Can Ince, PhD, Department of Intensive Care, Erasmus Medical Center, s-Gravendijkwal 230, 3015 CE Rotterdam, the Netherlands. Address e-mail to c.ince@erasmusmc.nl. © 2017 International Anesthesia Research Society

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