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Related Concept Videos

Colloids and Suspensions01:17

Colloids and Suspensions

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Children at play often make suspensions such as mixtures of mud and water, flour and water, or a suspension of solid pigments in water known as tempera paint. These suspensions are heterogeneous mixtures composed of relatively large particles visible to the naked eye or seen with a magnifying glass. They are cloudy, and the suspended particles settle out after mixing. The suspended particles in a suspension settle out after some time of mixing. The separation of particles from a suspension is...
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DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
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The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
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Continuous Renal Replacement Therapy01:30

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Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
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Coagulation01:06

Coagulation

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Colloidal solids are solid particles suspended in solution. They are usually negatively charged, attracting a compact primary layer of positively charged ions, which attract more counterions to form an electrical double layer. Electrostatic repulsion between the charged double layers prevents the particles from colliding, stabilizing the colloids. These solids are often undesirable because they can contain toxins that are difficult to remove. Coagulation is a technique that helps aggregate and...
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Colloids03:22

Colloids

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Children at play often make suspensions such as mixtures of mud and water, flour and water, or a suspension of solid pigments in water known as tempera paint. These suspensions are heterogeneous mixtures composed of relatively large particles that are visible to the naked eye or can be seen with a magnifying glass. They are cloudy, and the suspended particles settle out after mixing. On the other hand, a solution is a homogeneous mixture in which no settling occurs and in which the dissolved...
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Key Controversies in Colloid and Crystalloid Fluid Utilization.

Erin N Frazee1, David D Leedahl2, Kianoush B Kashani3

  • 1Hospital Pharmacy Services, Mayo Clinic , Rochester, Minnesota.

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Summary

Intravenous fluid choice remains critical. Evidence supports balanced crystalloids over normal saline and judicious use of albumin due to cost and safety concerns, impacting hospital pharmacy practice.

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Area of Science:

  • Clinical Pharmacy
  • Critical Care Medicine
  • Pharmacoeconomics

Background:

  • Intravenous fluid therapy is a cornerstone of clinical practice, yet optimal selection and use remain debated.
  • Key controversies include the role of albumin and the safety of normal saline (0.9% sodium chloride).
  • Albumin's high cost limits its use, while normal saline's chloride load raises safety concerns.

Purpose of the Study:

  • To review the evidence on human albumin use in acute care.
  • To evaluate the safety and role of balanced salt solutions compared to normal saline.
  • To guide hospital pharmacists in rational intravenous fluid selection.

Main Methods:

  • Literature review of recent investigations on intravenous fluid therapy.
  • Analysis of evidence regarding albumin's efficacy and cost-effectiveness.
  • Examination of studies on the safety profile of normal saline and balanced crystalloids.

Main Results:

  • Albumin has specific therapeutic roles but is less cost-effective than alternatives.
  • Normal saline (0.9% sodium chloride) is associated with renal dysfunction due to high chloride content.
  • Balanced crystalloids (e.g., Lactated Ringer's, Plasma-Lyte) offer a safer alternative by mimicking extracellular fluid composition.

Conclusions:

  • Hospital pharmacists must critically evaluate evidence for rational albumin use.
  • A practice shift towards balanced crystalloids is supported by safety data.
  • These fluid controversies will significantly influence future hospital pharmacy practice.