Cocktail-style multifunctional resuscitation fluids: Where are we now in 2026?

For over half a century, fluid resuscitation has traditionally included crystalloids for volume expansion and colloids for potential oncotic advantage. The paradigm, however, could be shifting now. The development of multifunctional resuscitation fluids is fast evolving. These fluids integrate multiple therapeutic components. Rather than serving as simple volume expanders, they function as advanced therapeutic platforms engineered to simultaneously target multiple pathological conditions. They correct hypovolemia, mitigate systemic inflammation and coagulopathy, improve organ perfusion and oxygen delivery, and support tissue recovery in conditions such as shock, endothelial dysfunction, and oxidative stress. This article reviews the basic concepts underpinning multifunctional resuscitation fluids and explores their potential clinical applications. It also assesses their advantages and limitations based on recent preclinical and early clinical trials, and outlines future directions necessary to translate these promising solutions from the bench to the bedside.