ABSTRACT
E. Starling's research established the effects of osmotic and hydrostatic pressures on fluid movement, forming the basis for twentieth-century approaches to fluid management. Fluid therapy has long been a topic of passionate, often conflicting, views. Incidence of heart failure in hospitalised patients is high, so infused fluids will only improve perfusion if the heart is able to pump it into arteries. Colloids were preferred to crystalloids for fluid resuscitation, as it was believed a smaller infusion volume was needed to maintain blood volume. Blood for transfusion can be obtained from: donors, recycling, and autotransfusion. Hypertonic albumin has a high osmotic pressure, drawing extravascular water into the bloodstream. Gelatins have mean molecular weights of 30,000–40,000, about half the molecular weight of albumin, and lower than renal threshold. Capillary permeability varies greatly, ranging from the blood–brain barrier to renal glomerulus.
