Noncolligative properties of intravenous fluids

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose of review: Currently available crystalloids were designed over a century ago for dehydration and not for the treatment of hemorrhagic shock. Information regarding fluids used for resuscitation has grown and thus resuscitation has changed radically in the last two decades. Artificial fluids such as crystalloids and other solutions typically used for resuscitation are now recognized to be inflammatory when infused at high volumes to replace blood. Recent findings: Recent studies have shown that the crystalloids and artificial colloids cause inflammation. Prehospital fluid use has not shown to be of benefit and permissive hypotension may be useful. Careful titration of fluids with minimizing crystalloids and early use of blood products have improved outcome after traumatic hemorrhagic shock. Summary: Seemingly innocuous fluids have a dose effect and can be detrimental. Crystalloids can create inflammation when used at high volumes and may be the reason for the sequelae seen after massive resuscitation. This has led to the recognition that whole blood is extremely complex and does much more than carry oxygen. Resuscitation has changed recently with the adoption of damage control resuscitation which is the practice of allowing permissive hypotension, minimizing crystalloids and early aggressive use of blood products. This has led to a decrease in multiple organ dysfunction syndrome and acute respiratory distress syndrome.

Original languageEnglish (US)
Pages (from-to)317-322
Number of pages6
JournalCurrent Opinion in Critical Care
Volume16
Issue number4
DOIs
StatePublished - Aug 2010

Fingerprint

Resuscitation
Hemorrhagic Shock
Hypotension
Traumatic Shock
Inflammation
Multiple Organ Failure
Adult Respiratory Distress Syndrome
Colloids
Dehydration
crystalloid solutions
Oxygen

Keywords

  • Acute respiratory distress syndrome
  • Blood
  • Crystalloids
  • Damage control
  • Fluids
  • Hemorrhagic
  • Inflammation
  • Multiple organ dysfunction syndrome
  • Plasma
  • Resuscitation
  • Shock
  • Trauma

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Noncolligative properties of intravenous fluids. / Rhee, Peter M.

In: Current Opinion in Critical Care, Vol. 16, No. 4, 08.2010, p. 317-322.

Research output: Contribution to journalArticle

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