The administration of intravenous fluids in the critically ill patient presents many challenges for clinicians. Intravenous fluids are usually categorized as either crystalloids or colloids, with each having distinct advantages and disadvantages in various patient populations. The appropriate selection of fluid type remains an issue of great debate in the critical care literature and has been the subject of numerous comparative studies. Despite the vast amount of data available, there is no clear consensus in the literature to direct the clinician in the choice of fluid type. This article will provide an overview of fluid distribution within the body and the factors that affect this distribution, a review of the various types of fluids administered in the critically ill patient, and the rationale for the selection of each type. A review of the literature surrounding the colloid-crystalloid controversy is provided.
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