Although controversy persists in this area, preferential use of crystalloids rather than colloids is supported by the available literature. For the same amount of volume expansion, there is no difference between these two treatments in terms of ejection stroke volume or oxygen delivery [49] . Systematic reviews and meta-analyses that included patients with sepsis and other types of patients concluded that crystalloids and colloids were generally similar in effect; an exception was one study that identified an advantage for crystalloids [50] . This finding received support from a randomized trial [51] that found that patients with septic shock receiving colloids had greater renal impairment. A recent study [52] was conducted to compare colloid with crystalloid volume resuscitation, with the aim being to identify the safest choice for use in patients with sepsis. This study, which employed a prospective randomized multicenter design, compared the influence on outcome of Ringer's lactate versus hydroxyethyl starch and of intensive versus conventional insulin therapy in patients with severe sepsis and septic shock. Experts have already criticized this study on the grounds that its design confounds applicability of the findings to routine daily care [53] . To summarize, although infusing fluids is a cornerstone of supportive care during sepsis, the optimal modalities and volume are difficult to determine and choices should be driven by objectives in the individual patient [48] .