This systematic review and meta-analysis, which included only high-level evidence from randomized, controlled trials (RCTs) conducted in intensive care settings, revealed that crystalloids were less effective than colloids at stabilizing hemodynamic resuscitation endpoints such as CVP, MAP, and cardiac index. There is a possibility that saline is more effective than balanced crystalloids at reaching resuscitation endpoints; however, the evidence for this was not conclusive and the known risks associated with saline must be noted. HES was the only colloid associated with increased mortality vs. crystalloids. Therefore, alternative fluid therapy with colloids such as albumin may be appropriate to restore hemodynamic endpoints in a more timely and effective manner.

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