Hypertonic versus isotonic crystalloid for fluid resuscitation in critically ill patients

Bunn, Frances; Roberts, Ian; Tasker, Robert C.; Akpa, E

doi:10.1002/14651858.cd002045

Cited by 29 publications

(23 citation statements)

References 22 publications

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“…There are insufficient data to make a recommendation for or against use of hypertonic saline for shock associated with head injuries or hypovolemia. 333,334 • There is insufficient evidence in infants and children to make a recommendation about the best timing or extent of volume resuscitation for children with hemorrhagic shock following trauma.…”

Section: Special Resuscitation Situations Septic Shockmentioning

confidence: 99%

Part 14: Pediatric Advanced Life Support

Kleinman¹,

Chameides²,

Schexnayder³

et al. 2010

Circulation

915

304

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Section: Special Resuscitation Situations Septic Shockmentioning

confidence: 99%

Part 14: Pediatric Advanced Life Support

Kleinman¹,

Chameides²,

Schexnayder³

et al. 2010

Circulation

915

304

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“…24 Published evidence of a survival benefit in resuscitation of patients with trauma has been equivocal, and a systematic review of literature published recently did not show any advantage of hypertonic crystalloid solutions over isotonic solutions for fluid resuscitation in patients who are critically ill. 4 However, this product may have an application for patients with severe brain injury because it may expand the circulating blood volume with less risk of the patient having cerebral edema develop.…”

Section: Discussionmentioning

confidence: 99%

Fluid Resuscitation and Blood Replacement in Patients with Polytrauma

Shafi¹,

Kauder²

2004

Clinical Orthopaedics and Related Research

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Hemorrhage is the most common cause of shock in patients with polytrauma, leading to cellular hypoxia and death. A large body of experimental and clinical research has greatly expanded our knowledge of cellular mechanisms and clinical outcomes in resuscitation of patients with hypovolemic shock. However, the fundamental principles of fluid resuscitation have not changed during the past few decades. Aggressive resuscitation to correct tissue hypoperfusion within 24 hours of injury is associated with improved clinical outcomes. Initial volume expanders of choice are crystalloid solutions, with blood and blood products used for patients who are hemodynamically unstable, patients with Class III and Class IV hemorrhage, and patients with ongoing uncontrolled sources of bleeding. The incidence of immunologic and infectious complications associated with blood transfusions in resuscitation of patients with polytrauma has not been shown to be any higher than in other clinical settings. Massive resuscitations, however, are associated with specific complications such as hypothermia, coagulopathy, and abdominal compartment syndrome. Novel blood substitutes, hypertonic saline, and minimally invasive hemodynamic monitoring techniques have the potential of optimizing fluid resuscitation in patients with polytrauma. Additional research using standardized animal models and randomized clinical trials is needed.

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“…An adequate volume status of both the ICS and ECS spaces is necessary to obtain this effect; so that, the prolonged usage of HCS crystalloid is not recommended (Maningas and Bellamy 1986;McIlroy and Kharasch 2003). Both Wade et al (1997) and Bunn et al (2002) reported, in their meta-analyses, no significant improvement in outcome in critical patients by using HCS. They hypothesized that the combined used of HCS and colloids would be superior to isotonic fluid resuscitation (Agrò and Vennari 2013b).…”

Section: Hypertonic Crystalloidsmentioning

confidence: 99%