CARDIO: COLLOIDS (PLASMA SUBSTITUTE)

Question 1

COLLOIDS (PLASMA SUBSTITUTES): INDICATIONS

Answer 1

• Expanding circulating volumes (circulatory compromise), including Shock [Compound sodium lactate, sodium chloride 0.9%]
• Cirrhotic Liver Dx = albumin used to prevent effective hypovoloemia (large-volume paracentesis - ascitic fluid drainage)

Question 2

COLLOIDS (PLASMA SUBSTITUTES): MOA

Answer 2

• Contains large osmotically active molecules
• Large molecules cannot readily diffuse out of vessel and their osmotic effect holds the infused fluid in the plasma
• Expand circulating volume (greater than crystalloids as as 20% of it remains in the plasma after distribution)
• Large volume paracentesis in Cirrhotic Liver Dx = Administer human albumin solution

Question 3

COLLOIDS (PLASMA SUBSTITUTES): ADVERSE EFFECTS

Answer 3

• Can precipitate cardiac failure by increasing left ventricular filling beyond a point of maximal contractility
• Most colloids contain a significant amount of sodium, produce odema
• Gelatins can cause hypersensitivity reactions, including anaphylaxis

Question 4

COLLOIDS (PLASMA SUBSTITUTES): WARNINGS

Answer 4

• Fluid volume should be reduced in patients with heart failure, due to risk of worsening myocardial contractility
• Renal impairment - monitor to avoid fluid overload

Question 5

COLLOIDS (PLASMA SUBSTITUTES): INTERACTIONS

Answer 5

• None