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Perioperative colloids: From theory to practice.

J L Jover Pinillos1, M Basora Macaya2, J Ripollés-Melchor3

  • 1Servicio de Anestesiología y Reanimación, Hospital Verge dels Lliris, Alcoy, Alicante, Spain.

Revista Espanola De Anestesiologia Y Reanimacion
|March 1, 2023
PubMed
Summary
This summary is machine-generated.

Perioperative colloid use is limited, primarily for patients experiencing significant bleeding. Hydroxyethyl-starch was the most common colloid, and its administration was linked to higher transfusion risks.

Keywords:
AnaemiaAnemiaBalanced crystalloidsColloidsColoidesCristaloidesCristaloides balanceadosCrystalloidsFluid therapyFluidoterapiaHemorragia perioperatoriaPerioperative bleeding

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Area of Science:

  • Anesthesiology
  • Critical Care Medicine
  • Surgical Fluid Management

Background:

  • Clinical guidelines recommend crystalloids over colloids for fluid resuscitation.
  • Perioperative fluid administration practices, particularly colloid use, remain unclear.
  • Understanding current colloid administration is crucial for optimizing patient care.

Purpose of the Study:

  • To describe the perioperative use of colloids.
  • To identify factors associated with colloid administration.
  • To analyze reasons for colloid use in clinical practice.

Main Methods:

  • Prospective, cross-sectional, national, multicenter observational study.
  • Analysis of data from 5928 patients undergoing surgery.
  • Inclusion of demographic, comorbidity, anesthetic, surgical, and fluid administration data.

Main Results:

  • 9.1% of patients received colloids, with hydroxyethyl-starch being most frequent (5.1%).
  • Colloid use was associated with longer surgeries, emergency operations, high-risk patients, and critical care unit recovery.
  • Significant perioperative bleeding (>500ml) and anemia increased colloid administration likelihood.

Conclusions:

  • Colloid administration in this setting is limited and closely tied to perioperative bleeding.
  • Colloid use was associated with increased risk of transfusion and advanced monitoring.
  • Current practices suggest cautious and indication-driven colloid administration.