In fluid therapy, when would colloids be preferred over crystalloids?

• A. In mild dehydration only.
• B. For all dehydration and electrolyte abnormalities.
• C. In severe hypotension or hypoalbuminemia.
• D. Never use colloids.

Answer: (C)

Colloids are most helpful when you urgently need to restore circulating blood volume because they stay in the intravascular space longer and raise oncotic pressure. This makes them ideal in severe hypotension or shock, where rapid perfusion is critical, or in hypoalbuminemia, where low oncotic pressure allows fluid to leak into tissues. Crystalloids spread quickly into the interstitial space, so they’re typically the first choice for milder dehydration or broader electrolyte corrections, but they’re less efficient at sustaining intravascular volume in serious cases. Therefore, the scenario described—severe hypotension or hypoalbuminemia—is when colloids offer the clear advantage.