Colloid vs. crystalloid infusions in gastrointestinal surgery and their different impact on the healing of intestinal anastomoses

Abstract

In case of a fixed, high-volume load, colloids seem to have benefits on intestinal anastomotic healing when compared to crystalloid infusions.

An observational study fluid balance and patient outcomes in the randomized evaluation of normal vs. augmented level of replacement therapy trial*

“…In addition, a possible causal relationship between a 2-and 3-kg fluidinduced gain in body weight (as seen in our patients) and outcome is supported by randomized controlled evidence (27) showing a progressive increase in complications (anastomotic breakdown, sepsis, bleeding, pulmonary edema, and arrhythmias), with increases from 0.5 to 2.5 to 2.5 kg in postoperative weight. Such complications appear biologically plausible because gut edema can weaken anastomotic strength (28) and function (29,30), excessive fluid therapy can induce dilutional coagulopathy (31), pulmonary edema can cause hypoxemia, which, in turn, can predispose to arrhythmias, and cardiac edema can also contribute to such complications (29).…”

Pitfalls and Technical Aspects during the Research of Intestinal Anastomotic Healing in Rats

“…The same perioperative conditions were applied in all rats, and the animals experienced the same anastomotic technique either for the small bowel or the colon, differing only in the individually examined variables. Specific data of the different studies have been published elsewhere [10][11][12][13][14][15] .…”

Anesthesia for Thoracic Surgical Procedures

“…Some animal models have demonstrated greater interstitial edema with crystalloid administration and better preserved effective capillary cross-sectional area in the colloid group [59]. Other studies conclude that when given in similar volumes, colloids are more beneficial for anastomotic healing than crystalloid [24,42]. Improved microcirculatory blood flow and tissue oxygen tension were observed after abdominal surgery in one animal model [60,61].…”

“…Restrictive fluid regimens were thought to result in better gastrointestinal recovery time, reduced overall morbidity [40], improved respiratory parameters, decreased incidence of postoperative pulmonary complications, and shorter recovery periods [41]. Conversely, fluid overload had a direct negative relationship to function and structure of the intestinal anastomoses [42].…”