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Updated: Jun 11, 2026
06:59
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Noncolligative properties of intravenous fluids
1University of Arizona, Tucson, Arizona 85724-5063, USA. prhee@surgery.arizona.edu
Current Opinion in Critical Care
|July 6, 2010
Summary
Modern resuscitation strategies for hemorrhagic shock emphasize minimizing crystalloid fluids due to their inflammatory potential. Early use of blood products and permissive hypotension improve outcomes, reducing organ dysfunction and respiratory distress.
Area of Science:
- Trauma resuscitation
- Hemorrhagic shock management
- Fluid therapy research
Background:
- Crystalloids, designed for dehydration, are inadequate for hemorrhagic shock.
- Resuscitation protocols have evolved significantly over the past two decades.
- High-volume crystalloid and artificial colloid infusions can induce inflammation.
Purpose of the Study:
- To review current understanding of fluid resuscitation in hemorrhagic shock.
- To highlight the inflammatory effects of traditional resuscitation fluids.
- To discuss the shift towards damage control resuscitation.
Main Methods:
- Review of recent studies on crystalloids, colloids, and blood products.
- Analysis of prehospital fluid use and permissive hypotension.
- Evaluation of outcomes associated with different resuscitation strategies.
Main Results:
- Crystalloids and artificial colloids are associated with inflammation.
- Prehospital fluid administration has not demonstrated clear benefits.
- Minimizing crystalloids and early blood product use improve outcomes in traumatic hemorrhagic shock.
Conclusions:
- Crystalloids can be detrimental at high volumes, potentially causing post-resuscitation sequelae.
- Whole blood possesses complex functions beyond oxygen transport.
- Damage control resuscitation, incorporating permissive hypotension and early blood products, reduces multiple organ dysfunction and acute respiratory distress syndrome.
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