الفهرس 
Introduction and Aim of the workOnly 14 pages are availabe for public view
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Abstract
The need for fluid resuscitation, or replacing blood
volume is to maintain adequate organ perfusion. Options
include colloids such as albumin or hydroxyl ethyl starch and
crystalloids such as normal saline or lactated Ringer’s solution.
One often cited advantage of using colloids that less
volume is needed to produce the desired effect Safety and cost
are two major arguments against the use of colloids, along
with the lack of evidence for benefit over crystalloids in many
patient populations. Recently, findings have suggested that
intravenous fluids may be harmful if given in excess
(quantitative toxicity) and that some may be more harmful
than others (qualitative toxicity), particularly for patients who
already have AKI. Recent clinical trials have investigated
hydroxyl ethyl starch solutions and found worrying results for
the renal community.
Colloids can be distinguished as being synthetic
(gelatins, dextrans, and starches) or non-synthetic (derived
from plasma, hereinafter referred to as albumin as the
predominant available form). Each type is associated with
several real or hypothetical risks. For example, synthetic
colloids have been associated with co-agulopathy,
anaphylactoid reactions, and end-organ damage, whereas albumin is derived from pooled plasma collection, and thus
carries the potential risk of infection. Low serum albumin
levels have been associated with poor survival in critically ill
patients, and hypo proteinemia is a licensed indication for
albumin therapy. Intravenous solutions consume a substantial
portion of pharmacy budgets, with crystalloids being less
expensive than colloids, and albumin the most costly.