Which is the best initial fluid for resuscitation during the shock state:
Crystalloids predominantly expand the interstitial and then the intracellular compartment not the intravascular compartment (expansion of intravascular compartment is only transient). This is necessary to replenish the intracellular and interstitial compartment as in a hypovolemic patient, the shock induced homeostasis has already shifted the intracellular and interstitial fluid into the vascular compartment.
Colloids on the other hand cause expansion of the vascular compartment; colloids imbibe fluid from the interstitial and intracellular compartment thus further compromising the already depleted intracellular compartment. Hence crystalloids are the initial fluid of choice.
Examples of Crystalloids: Ringer lactate (most commonly used crystalloid), Normal saline, 5 % Dextrose, Isolyte Examples of Colloids: Albumins, Dextrans, Hydroxyethyl starches(HES), Gelatins
Crystalloids
Colloids
Blood
Plasma substitutes