Which fluid is a synthetic colloid historically used for resuscitation but now less favored due to potential coagulopathy and kidney injury?

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Synthetic colloids used for resuscitation carry safety concerns. Hetastarch, a hydroxyethyl starch, was historically used to expand intravascular volume, but evidence shows it can impair coagulation by diluting clotting factors and reducing platelet function, and it is associated with kidney injury. These risks led to decreased use and regulatory warnings, so it’s treated as a fluid to avoid when resuscitating patients. In contrast, crystalloids like normal saline or lactated Ringer’s are preferred for volume replacement because they expand the intravascular space with a lower risk of coagulopathy and renal injury. 5% dextrose in water is not a good resuscitation fluid either, since it becomes hypotonic after metabolism and won’t reliably sustain intravascular volume. So the best choice here is hetastarch due to its historically widespread use but later recognition of harm to coagulation and kidneys.