Ross A D, Angaran D M
Drug Intell Clin Pharm. 1984 Mar;18(3):202-12. doi: 10.1177/106002808401800305.
The crystalloid vs. colloid controversy is based on a disagreement as to the most effective, safest, and most economical method of maintaining an effective plasma volume in shock patients. This review discusses Starling's law of fluid movement, with a definition of each term in the normal physiological state, and presents examples of how each component of Starling's law differs in the two major types of pulmonary edema: (1) cardiogenic and (2) noncardiogenic. The colloid-crystalloid literature is reviewed briefly with an emphasis on the major studies that support each side, and the deficiencies in each study. The arguments supporting each side of the crystalloid-colloid debate are then listed, with a summary that demonstrates the areas of agreement between the two schools of thought on fluid resuscitation. Each major colloid (albumin, dextran, hetastarch) and a representative crystalloid (lactated Ringer's) are discussed in terms of their chemistry; pharmacology and indications; and precautions, adverse reactions, and side effects. A table is included that summarizes the available products' data regarding composition, volume expansion, duration of expansion, half-life, metabolism, elimination, precautions, adverse reactions, and dose.
晶体液与胶体液之争基于对休克患者维持有效血浆容量的最有效、最安全和最经济方法存在分歧。本综述讨论了斯塔林流体运动定律，对正常生理状态下的每个术语进行了定义，并举例说明了斯塔林定律的每个组成部分在两种主要类型的肺水肿（1）心源性和（2）非心源性中的差异。简要回顾了胶体液与晶体液的文献，重点是支持双方的主要研究以及每项研究的不足之处。然后列出了支持晶体液 - 胶体液争论双方的论点，并进行总结，展示了两派在液体复苏方面的共识领域。从化学、药理学和适应证以及注意事项、不良反应和副作用等方面讨论了每种主要胶体（白蛋白、右旋糖酐、羟乙基淀粉）和一种代表性晶体液（乳酸林格氏液）。文中包含一个表格，总结了现有产品关于成分、容量扩充、扩充持续时间、半衰期、代谢、消除、注意事项、不良反应和剂量的数据。
