Drug intelligence & clinical pharmacy
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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. ⋯ 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.