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Crystalloids and colloids in trauma resuscitation: a brief overview of the current debate
1Department of Surgery, Sunnybrook and Women's College Health Science Centre, University of Toronto, Ontario, Canada. sandro.rizoli@sw.ca
Background:
Controversy regarding crystalloids or colloids for resuscitation has existed for over five decades, and large numbers of clinical trials have failed to resolve the controversy. In fact, the limitations of these studies have intensified the debate. This overview aims to revisit the debate of fluid resuscitation in trauma patients by critically appraising the meta-analyses on the subject.
Methods:
This study was a critical analysis of six meta-analyses found by MEDLINE search.
Results:
Overall, the choice of fluid may have a small or no effect on mortality. In trauma, the use of colloids is associated with a trend toward increased mortality.
Conclusion:
There is an urgent need for well-designed clinical trials. Because of many limitations, meta-analysis should be interpreted with caution, possibly as hypothesis generating. However, even considering all weaknesses and nuances of interpretation, the meta-analyses reviewed suggest that trauma patients should continue to be resuscitated with crystalloids.