MT2: COLLOIDS

• Colloids- contains proteins and other large molecular substances that increases osmolarity without dissolving the solution.
• Large particles in colloids are unable to pass through the semi-permeable membrane of the capillary wall.
• Colloids- its substances stay within the intravascular compartment which makes it known as the "plasma expander"
• colloids- are hypotonic solutions
• Substances in colloid solutions are: PROTEINS and POLYSACCHARIDES
• Colloids


  acts to increase the colloidal oncotic pressure which pulls the fluid from interstitial space into the plasma, thus, increasing blood volume.
• Composition of Colloids:

  • proteins
  • carbohydrates
  • lipids
• Colloids- have typically small and larger molecules except for Albumin, since its particles are equal in size.
• Examples of colloids:

  • albumin
  • dextran
  • hydroxyethyl starch
  • haemaccel
  • gelofucine
• Indications of colloids:

  • fluid resuscitation - patients with severe intravascular deficits (hemorrhagic shock) prior to arrival of blood transfusion.
  • fluid resuscitation- presence of severe hypoalbuminemia or conditions that causes large loses of proteins such as burns.
• Albumin- is a natural colloid and an isotonic solution prepared as 5% or 25%.
• Indications of Albumin:

  • Plasma expander used to maintain blood volume
  • STBS - Sepsis, Trauma, Burns, Shock
  • Hypoproteinemia
• Hydroxyethyl starch- used as plasma expander in Hypovolemia due to STBS
• Pre-loading and hemodilution- are concepts related to the use of hydroxyethyl starch for fluid management, particularly in surgical and critical care areas.
• Pre-loading - the administration of IV before a surgical procedure or early stages of treatment to expand blood volume.
• hydroxyethyl starch (pre-loading)


  this solution is often done in anticipation of fluid losses during surgery or when rapid volume expansion is needed, such as in trauma cases.
• Hemodilution- involves the dilution of blood components through a volume expander.
• Colloids (Blood and blood products)- include whole blood and the components that can be processed through centrifugation.
• Parts of the Blood:

  • Packed RBCs
  • Plasma
  • Platelets
  • Cryoprecipitate
• Plasma


  can further be processed into volume expander, coagulation factor concentrates and immune globulins.
• Unit packed RBCs- contains concentrated RBCs wherein most plasma and platelets are removed.
• Approximate volume of a unit packed RBC

  • 350 ml/unit
• Approximate volume of a unit whole blood

  • 500 ml/unit
• Unit packed RBCs


  are red blood cells that have been separated from plasma and other blood components. They are typically used for transfusions to treat anemia, blood loss from surgery or trauma, and other conditions requiring increased red blood cell mass.
• Advantages of infusing packed RBCs over whole blood:

  • allows an increase in oxygen-carrying capacity with smaller volume
  • maximum infusion rate is 4 hrs / unit
• One unit of whole blood elevates:

  • Hemoglobin by 0.5 to 1 g/dl
  • Hematocrit by 3 points.
• Principles of Blood Transfusion include:

  • Whole blood transfusion
  • Packed RBCs
  • Platelets
  • Granulocytes
  • Plasma
• whole blood transfusion 


  indicated only for patients who need both increased oxygen-carrying capacity and restoration of blood volume when time is limited in obtaining specific blood components.
• Packed RBCs


  are concentrated RBCs separated from plasma indicated to treat anemia, significant blood loss, or low hemoglobin levels.
• Packed RBCs- must be transfused 2-3 hours. If patient can't tolerate the maximum 4 hours, blood bank may divide into smaller volume, with proper refrigeration.
• One unit of packed RBCs elevates:

  • Hemoglobin - 1%
  • Hematocrit - 3%
• Platelets


  component is derived from whole blood containing platelets for clotting. It used for patients with thrombocytopenia due to bone marrow disorders, chemotherapy, or massive transfusions.
• Platelet BT Indications:

  • administered as rapidly as possible, usually 4 units every 30 to 60 mins.
• Each unit of platelets should raise:

  • 6000 to 10,000 / mm3
• In platelet transfusion- poor incremental increases with alloimmunization, previous transfusions, bleeding, fever, infections, autoimmune destruction, and hypertension.
• Granulocyte 


  used in patients with severe neutropenia or infections unresponsive to antibiotics.
• Granulocyte transfusions- may be beneficial in severely granulocytopenic patients (<500 / mm3), unresponsive to antibiotics, prolonged suppressed granulocyte production.
• Plasma


  carries a risk of hepatitis equal to the whole blood.
• Plasma Transfusion indication:

  • Fresh frozen plasma - must be administered as rapidly as tolerated, because coagulation becomes unstable after thawing.
• Solutions preferred for volume expansion:

  • Colloids (albumin)
  • Electrolyte solutions (LR)