Crystalloid vs colloid fluid resuscitation in polytrauma patients: a systematic review

The question of whether crystalloid or colloid fluid yields better outcomes in the treatment of polytrauma patients has recently garnered significant interest. This systematic review aims to comprehensively compare the effects of crystalloid versus colloid fluid resuscitation on treatment outcomes in polytrauma patients.

We searched PubMed, Cochrane Central Register of Controlled Trials and Web of Science to identify completed and ongoing studies from inception of each database to August 9, 2022. We included systematic reviews and randomized controlled trials (RCTs) comparing crystalloid versus colloid fluid resuscitation on treatment outcomes in polytrauma patients admitted to the intensive care unit (ICU).

We included one RCT with a total of 2,857 adult participants (mean age 63 years in the colloids and crystalloids group, 62.2% male in the colloids group and 62.5% male in the crystalloids group). Our findings indicate that the administration of crystalloids does not significantly differ from colloids in terms of 28-day mortality among polytrauma patients. (HR 1.19; 95% CI 0.54 to 2.62; RD 23 more per 1000, 95% CI 58 fewer to 174 more, 1 study, 177 participants, very low quality of evidence).

Crystalloid volume therapy has no significant difference on adult polytrauma patients compared to colloid volume therapy regarding mortality.