Indian journal of anaesthesia
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The administration of intravenous fluids is one of the most common and universal interventions in medicine. Colloids are an alternative to the frequently used crystalloids, with highly variable use depending on a myriad of clinical variables. A colloid is defined as a high molecular weight (MW) substance that largely remains in the intravascular compartment, thereby generating an oncotic pressure. ⋯ Thus, among the synthetic colloids, the tetrastarches appear to offer the best currently available compromise between efficacy, safety profile, and cost. They also appear to be the best suited for use in the intensive care setting. Finally, balanced (rather than saline-based) HES solutions appear promising as a plasma-adapted volume replacement strategy and may further refine the ongoing quest of finding the ideal fluid therapy.
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The Centers for Disease Control and Prevention (CDC) reported in 2003 that although the maternal mortality rate has decreased by 99% since 1900, there has been no further decrease in the last two decades1. A more recent report indicates a rate of 11.8 per 100,000 live births2, although anaesthesia-related maternal mortality and morbidity has considerably decreased over the last few decades. ⋯ The rates of general anaesthesia for cesarean delivery have decreased and neuraxial anaesthetics have become the most commonly used techniques. Neuraxial techniques are largely safe and effective, but potential complications, though rare, can be severe.