Colloids: Current recommendations

Colloids are increasingly becoming considered indispensable in the management of critically ill patients. Typical indications for colloid administration include patients with tissue edema, hypovolemia, and low oncotic pressure. Current guidelines for the use of colloids in veterinary patients balance the purported benefits of colloid fluid administration with the potential risks, such as volume overload and coagulation disturbances. This article focuses primarily on hydroxyethyl starches, because they are the most commonly used colloid in veterinary practice, and because recent advances in colloid therapy have been achieved with this colloid. Newer colloids have been modified to limit effects on the coagulation system, and they may be used to modulate the inflammatory response, which could prove to be particularly useful in the management of critically ill patients. A better understanding of how different fluids influence the host response may enable us to explore new applications of fluid replacement therapy beyond simply replenishing volume deficits.