2. Colloidal solution
The colloidal solution is used to increase the plasma content to avoid penetrating the semipermeable membrane with large molecular weight of the solute. It does not cause edema and may even decrease edema in high concentrations. Blood transfusion, albumin, mannitol, destran, etc. are common components of this type of solution. Blood transfusion is the most widely used form of colloidal solution and is the most effective remedy in severe hemorrhage or anemia.
Albumin is an important component of colloidal solution and was used for increasing the blood volume in patients with renal failure or liver cirrhosis who have decreased serum albumin levels. Two concentrations of 5% and 20% are available. The 5% albumin concentration has the same concentration to that of plasma. The 20% albumin solution can maintain 4 times as high plasma volume for 12-18 hours due to its high osmotic pressure. I believe patients find albumin therapy particularly invigorating due to its edema-reducing effects.
Mannitol is a type of sugar alcohols obtained from hydrogen reduction of fructose. It inhibits reabsorption of water Na+ to increase urination. Therefore, it is often used in patients with acute intracranial hypertension or intraocular hypertension. It can also help increase urination or reduce edema in renal failure. However, its diuretic effect is stronger with water than Na+ and has the risk of hypernatremia. Frequent use can also lead to acute renal failure due to renal blood vessel contraction.
Dextran is a glucose polymer of polysaccharides. It can be used to replace blood in severe shock or blood loss. However, it has thrombolytic effect and delays hemostasis.
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3. Nutrient IV solution
Nutrient IV solutions were developed for the purpose of providing immediate nutrition. Glucose solution, a type of crystaloid solution, can be used as IV nutrition. Other extensively used IV nutrition therapies include amino acids and lipids IV solutions. I would like to emphasize the benefits of all-in-one IV solution. It may be help us to briefly discuss the history of lipid solution. Lipid solutions can be divided into three generations.
Similar to carbohydrates, IV infused amino acids generally produce 4kcal per gram. However, amino acids is used for release of enzymes, and protein synthesis, etc., rather than caloric supplementation. One can see numbers such as 88%, 96% on the packaing of IV infused amino acids. These numbers do not refer to the concentration of amino acids. The amino acid concentration is limited to about 10-15% of the entire solution. Next to the percentage one will find initials such as BCAA/TAA or EAA/TAA. In other words, these numbers describe the percentage of branched chain amino acid (BCAA) or essential amio acid (EAA) out of total amino acid (TAA). This is important because a choice between BCAA and EAA has different effects.
-To be continued
